2027 ICD-10-CM Diagnosis Code K42.1Umbilical hernia with gangrene
ICD-10-CM Codes›K00–K95›K40-K46›K42
- Billable — Valid for Submission
- MCC — Major Complication or Comorbidity
- Not Chronic
K42.1 is a billable ICD-10-CM diagnosis code for umbilical hernia with 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 major complication or comorbidity (MCC) and places an inpatient stay in the highest severity level of its MS-DRG family. It does not count, however, when the principal diagnosis is one of 19 closely related codes. In AHRQ's Clinical Classifications Software (CCSR), this diagnosis falls under Abdominal hernia and Gangrene.
Code Identity
Code Classification
Approximate SynonymsGuidance
Alternate terms and clinical phrases that map to this code.
- Congenital omphalocele
- Congenital umbilical hernia
- Gangrene due to recurrent umbilical hernia
- Obstructed umbilical hernia
- Omphalocele with gangrene
- Paraumbilical hernia
- Paraumbilical hernia with gangrene
- Paraumbilical hernia with gangrene AND obstruction
- Paraumbilical hernia with obstruction
- Umbilical hernia with gangrene
- Umbilical hernia with gangrene AND obstruction
Instructional NotesGuidance
Instructions from the official ICD-10-CM Tabular List that apply to K42.1: 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.
- Gangrenous umbilical hernia
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 K42.1, its category, or a range that includes it.
Excludes1 3
These codes carry an Excludes1 note naming K42.1: they are not reported together with it, unless the two conditions are unrelated.
- I96 Gangrene, not elsewhere classifiedgangrene in hernia (K40.1, K40.4, K41.1, K41.4, K42.1, K43.1-, K44.1, K45.1, K46.1)
- Q79.2 Exomphalosumbilical hernia (K42.-) names K42.-, which includes this code
- Q79.5 Other congenital malformations of abdominal wallumbilical hernia (K42.-) names K42.-, which includes this code
Index to Diseases and InjuriesGuidance
Alphabetical index entries that point to this code.
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
Gangrene
Gangrene is the death of tissues in your body. It happens when a part of your body loses its blood supply. Gangrene can happen on the surface of the body, such as on the skin, or inside the body, in muscles or organs. Causes include:
Read the full article at MedlinePlus
Courtesy of MedlinePlus, a service of the U.S. National Library of Medicine.
Convert K42.1 to ICD-9-CMHistory
The closest ICD-9-CM equivalents under the General Equivalence Mappings.
Code HistoryHistory
Questions About K42.1Overview
What is the ICD-10 code for umbilical hernia with gangrene?
The ICD-10-CM code for umbilical hernia with gangrene is K42.1 (sometimes written as K421). It is billable on HIPAA-covered claims from October 1, 2026 through September 30, 2027.
Is K42.1 (Umbilical hernia) a billable code?
Yes. This is a billable ICD-10-CM code, specific enough to report umbilical hernia with gangrene on HIPAA-covered claims from October 1, 2026 through September 30, 2027.
What MS-DRG does K42.1 group to?
When umbilical hernia with 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 K42.1 a CC or MCC?
CMS lists K42.1 as an MCC (major complication or comorbidity) for FY 2027. Reported as a secondary diagnosis, it places the inpatient stay in the highest-weighted DRG of its severity family. It does not count when the principal diagnosis is one of the 19 closely related codes in its exclusion list.
Can K42.1 be reported with Q79.2?
Not as a rule. The Excludes1 note at K42, which applies to K42.1, 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).
