2027 ICD-10-CM Diagnosis Code K42.0Umbilical hernia with obstruction, without gangrene
ICD-10-CM Codes›K00–K95›K40-K46›K42
- Billable — Valid for Submission
- CC — Complication or Comorbidity
- Not Chronic
K42.0 is a billable ICD-10-CM diagnosis code for umbilical hernia with obstruction, without gangrene. It is valid on HIPAA claims for fiscal year 2027 (October 1, 2026 through September 30, 2027) and groups to MS-DRG 393 through 395, 791, 793. As a secondary diagnosis, it counts as a complication or comorbidity (CC) and moves an inpatient stay to a higher severity level within its MS-DRG family. It does not count, however, when the principal diagnosis is one of 11 closely related codes. Coders also document this condition as intestinal obstruction due to recurrent umbilical hernia. In AHRQ's Clinical Classifications Software (CCSR), this diagnosis falls under Abdominal hernia and Intestinal obstruction and ileus.
Code Identity
Code Classification
Approximate SynonymsGuidance
Alternate terms and clinical phrases that map to this code.
- Intestinal obstruction due to recurrent umbilical hernia
- Irreducible paraumbilical hernia
- Irreducible umbilical hernia
- Obstructed umbilical hernia
- Paraumbilical hernia
- Paraumbilical hernia with obstruction
- Strangulated hernia of anterior abdominal wall
- Strangulated paraumbilical hernia
- Strangulated umbilical hernia
Instructional NotesGuidance
Instructions from the official ICD-10-CM Tabular List that apply to K42.0: its own notes plus those printed at K42, block K40-K46, and Chapter 11. A note printed at a category, block or chapter applies to every code under it.
Includes
Further defines, or gives examples of, the content of the category.
- paraumbilical hernia
- acquired hernia
- congenital [except diaphragmatic or hiatus] hernia
- recurrent hernia
Applicable To
Conditions this code is used for: synonyms of the title or, for "other specified" codes, the conditions assigned to it. The list is not exhaustive.
- Umbilical hernia causing obstruction, without gangrene
- Incarcerated umbilical hernia, without gangrene
- Irreducible umbilical hernia, without gangrene
- Strangulated umbilical hernia, without gangrene
Excludes1
Not coded here: the excluded code is never reported together with this one, unless the two conditions are unrelated.
Excludes2
Not included here: the excluded condition is not part of this code, but a patient may have both, so both codes may be reported.
- certain conditions originating in the perinatal period (P04-P96)
- certain infectious and parasitic diseases (A00-B99)
- complications of pregnancy, childbirth and the puerperium (O00-O9A)
- congenital malformations, deformations and chromosomal abnormalities (Q00-Q99)
- endocrine, nutritional and metabolic diseases (E00-E88)
- injury, poisoning and certain other consequences of external causes (S00-T88)
- neoplasms (C00-D49)
- symptoms, signs and abnormal clinical and laboratory findings, not elsewhere classified (R00-R94)
Notes
General instructions on how these codes are used.
- Hernia with both gangrene and obstruction is classified to hernia with gangrene.
Source: CMS ICD-10-CM Tabular List. How to read instructional notes.
Referenced in Other NotesGuidance
Instructional notes printed at other codes that name K42.0, its category, or a range that includes it.
Excludes1 2
These codes carry an Excludes1 note naming K42.0: they are not reported together with it, unless the two conditions are unrelated.
Index to Diseases and InjuriesGuidance
Alphabetical index entries that point to this code.
exomphalos K42.0
omphalocele K42.0
sarcoepiplomphalocele K42.0
Clinical ClassificationClinical
AHRQ’s CCSR groups this code into broader clinical categories.
Clinical InformationClinical
Hernia, Umbilical
a hernia due to an imperfect closure or weakness of the umbilical ring. it appears as a skin-covered protrusion at the umbilicus during crying, coughing, or straining. the hernia generally consists of omentum or small intestine. the vast majority of umbilical hernias are congenital but can be acquired due to severe abdominal distention.
Patient EducationClinical
Hernia
A hernia happens when part of an internal organ or tissue bulges through a weak area of muscle. Most hernias are in the abdomen.
Read the full article at MedlinePlus
Courtesy of MedlinePlus, a service of the U.S. National Library of Medicine.
Convert K42.0 to ICD-9-CMHistory
The closest ICD-9-CM equivalents under the General Equivalence Mappings.
Code HistoryHistory
Questions About K42.0Overview
What is the ICD-10 code for umbilical hernia with obstruction, without gangrene?
The ICD-10-CM code for umbilical hernia with obstruction, without gangrene is K42.0 (sometimes written as K420). It is billable on HIPAA-covered claims from October 1, 2026 through September 30, 2027.
Is K42.0 (Umbilical hernia) a billable code?
Yes. This is a billable ICD-10-CM code, specific enough to report umbilical hernia with obstruction, without gangrene on HIPAA-covered claims from October 1, 2026 through September 30, 2027.
What MS-DRG does K42.0 group to?
When umbilical hernia with obstruction, without gangrene is the principal diagnosis on an inpatient stay, it groups to MS-DRG 793, 791, 394, 395, 393, with relative weights from 0.6379 to 4.2192 depending on complications. Higher weights mean higher Medicare reimbursement.
Is K42.0 a CC or MCC?
CMS lists K42.0 as a CC (complication or comorbidity) for FY 2027. Reported as a secondary diagnosis, it moves the inpatient stay to a higher-weighted DRG within its severity family. It does not count when the principal diagnosis is one of the 11 closely related codes in its exclusion list.
Can K42.0 be reported with Q79.2?
Not as a rule. The Excludes1 note at K42, which applies to K42.0, lists "omphalocele (Q79.2)". An Excludes1 note means the excluded code is never reported together with this one; the only exception is when the two conditions are unrelated to each other (Official Guidelines, Section I.A.12.a).
