2027 ICD-10-CM Diagnosis Code K43Ventral hernia

ICD-10-CM Codes›K00–K95›K40-K46›K43

ICD-10-CM K43
CMSSource: CMS FY 2027 ICD-10-CM dataset · Effective Oct 1, 2026 – Sep 30, 2027

K43 is a non-billable ICD-10-CM category code for ventral hernia, so it cannot be submitted on claims. Use a more specific code from this category instead, such as K43.0, K43.1, K43.2, and K43.3.

Code Identity

ICD-10-CM Code
K43
Billable Status
No — Non-Billable Category
Code Describes
Ventral hernia
Short Description
Ventral hernia
Same as the full description in the CMS dataset.
Chapter
K40-K46
Hernia

Code Classification

ChapterK00–K95Diseases of the digestive system
SectionK40-K46Hernia
CategoryK43Ventral hernia
This CodeK43Ventral hernia

Specific Coding for Ventral herniaOverview

Non-specific codes like K43 require more characters. Use one of these billable codes instead:

  • Use K43.0 for Incisional hernia with obstruction, without gangrene

  • Use K43.1 for Incisional hernia with gangrene

  • Use K43.2 for Incisional hernia without obstruction or gangrene

  • Use K43.3 for Parastomal hernia with obstruction, without gangrene

  • Use K43.4 for Parastomal hernia with gangrene

  • Use K43.5 for Parastomal hernia without obstruction or gangrene

  • Use K43.6 for Other and unspecified ventral hernia with obstruction, without gangrene

  • Use K43.7 for Other and unspecified ventral hernia with gangrene

  • Use K43.9 for Ventral hernia without obstruction or gangrene

Instructional NotesGuidance

Instructions from the official ICD-10-CM Tabular List that apply to K43: its own notes plus those printed at 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.

From Block K40-K46 Hernia applies to 45 codes
  • acquired hernia
  • congenital [except diaphragmatic or hiatus] hernia
  • recurrent hernia

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.

From Chapter 11 (K00-K95) Diseases of the digestive system applies to 863 codes
  • 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.

From Block K40-K46 Hernia applies to 45 codes
  • 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 K43, its category, or a range that includes it.

Excludes2 1

These codes carry an Excludes2 note naming K43: its condition is not part of those codes, and both may be reported when the patient has both.

  • K56.7 Ileus, unspecified
    intestinal obstruction with hernia (K40-K46) names K40-K46, which includes this code

Clinical InformationClinical

  • Hernia, Ventral

    a hernia caused by weakness of the anterior abdominal wall due to midline defects, previous incisions, or increased intra-abdominal pressure. ventral hernias include umbilical hernia, incisional, epigastric, and spigelian hernias.

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.

Code HistoryHistory

FY 2016AddedAdded to the ICD-10-CM code setEffective October 1, 2015, the first year of ICD-10-CM.
FY 2017–2026No changes
FY 2027CurrentCurrent code set, no changesEffective October 1, 2026 through September 30, 2027.

Questions About K43Overview

What is the ICD-10 code for ventral hernia?

K43 is the ICD-10-CM category for ventral hernia, but it is a non-billable header: claims need a more specific code from this category, listed on this page.

Is K43 (Ventral hernia) a billable code?

No. This is a category header that groups the codes for ventral hernia, and headers cannot be submitted on claims. Claims for ventral hernia need a more specific code from this category, such as K43.0, K43.1, and K43.2.