ICD Code K40.90

ICD code K40.90 is a medical classification used to identify a unilateral inguinal hernia that does not involve any obstruction or gangrene and is not specified as recurrent. This code is utilized in healthcare documentation to accurately describe a condition where a hernia occurs on one side of the groin area, without complications such as tissue death or blockage, and without a history of previous occurrences.

When considering the use of the ICD code for a unilateral inguinal hernia without obstruction or gangrene, not specified as recurrent, healthcare providers should evaluate the following diagnostic criteria and symptoms:

1. Presence of a Bulge or Lump: Identify a noticeable bulge or lump in the groin area, which may become more apparent when the patient is standing or coughing.

2. Pain or Discomfort: Assess for any pain or discomfort in the groin, especially during physical activities, lifting, or bending.

3. Unilateral Presentation: Confirm that the hernia is present on only one side of the groin.

4. Absence of Obstruction: Ensure there are no signs of bowel obstruction, such as severe abdominal pain, nausea, vomiting, or inability to pass gas or stool.

5. Absence of Gangrene: Verify that there are no symptoms indicating gangrene, such as severe pain, discoloration, or tissue necrosis in the affected area.

6. Non-recurrent Condition: Determine that the hernia is not specified as recurrent, meaning it is the first occurrence or there is no documented history of previous hernia repair in the same location.

7. Physical Examination Findings: Conduct a thorough physical examination to confirm the presence of the hernia, typically felt as a soft mass that can be pushed back into the abdomen (reducible).

By systematically evaluating these criteria, healthcare providers can accurately determine the appropriate use of this specific ICD code in their documentation and billing processes.

For the ICD code K40.90, which pertains to a unilateral inguinal hernia without obstruction or gangrene, not specified as recurrent, the relevant CPT codes for treatment may include:

1. 49505 - Repair initial inguinal hernia, age 5 years or older; reducible.

2. 49507 - Repair initial inguinal hernia, age 5 years or older; incarcerated or strangulated.

3. 49520 - Repair recurrent inguinal hernia, any age; reducible.

4. 49521 - Repair recurrent inguinal hernia, any age; incarcerated or strangulated.

5. 49650 - Laparoscopy, surgical; repair initial inguinal hernia.

6. 49651 - Laparoscopy, surgical; repair recurrent inguinal hernia.

These CPT codes are typically used to document and bill for the surgical procedures associated with the treatment of an inguinal hernia as described by ICD code K40.90. It's important for healthcare providers to select the appropriate CPT code based on the specific details of the procedure performed.

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