K43
K43 — Ventral hernia
Non-billable headerICD-10-CM
K43 is a non-billable header ICD-10-CM code for ventral hernia. It cannot be billed on its own: choose one of the more specific child codes below.
Other codes that can never be billed with K43
These codes carry an Excludes1 note pointing at K43. The conflict binds both ways, but ICD-10-CM only writes it down on one side — so you would not find this by reading K43 alone.
- I96Gangrene, not elsewhere classified
Risk adjustment
K43 does not map to an HCC and does not risk-adjust under CMS-HCC V28. That is normal — most ICD-10 codes do not. It still needs to be coded correctly; it just will not move a RAF score.
Code to one of these instead K43
9 child codes. Green means billable.
- K43.0Incisional hernia with obstruction, without gangrene
- K43.1Incisional hernia with gangrene
- K43.2Incisional hernia without obstruction or gangrene
- K43.3Parastomal hernia with obstruction, without gangrene
- K43.4Parastomal hernia with gangrene
- K43.5Parastomal hernia without obstruction or gangrene
- K43.6Other and unspecified ventral hernia with obstruction, without gangrene
- K43.7Other and unspecified ventral hernia with gangrene
- K43.9Ventral hernia without obstruction or gangrene
Questions about K43
- Is K43 a billable ICD-10-CM code?
- No. K43 is a non-billable header code. Code to a higher level of specificity using one of its child codes.
- Where does K43 sit in the tabular list?
- Diseases of the digestive system (K00-K95), in the block Hernia (K40-K46).