2027 ICD-10-CM Diagnosis Code K43.1Incisional hernia with gangrene
ICD-10-CM Codes›K00–K95›K40-K46›K43
- Billable — Valid for Submission
- MCC — Major Complication or Comorbidity
- Not Chronic
K43.1 is a billable ICD-10-CM diagnosis code for incisional 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.
- Incisional hernia with gangrene
- Incisional hernia with obstruction
- Incisional ventral hernia with gangrene
- Obstructed incisional hernia with gangrene
- Obstructed incisional ventral hernia
- Obstructed ventral incisional hernia with gangrene
- Postoperative intestinal obstruction
- Recurrent hernia of anterior abdominal wall with gangrene
- Recurrent incisional hernia
- Recurrent ventral incisional hernia
- Recurrent ventral incisional hernia with gangrene
- Ventral incisional hernia
Instructional NotesGuidance
Instructions from the official ICD-10-CM Tabular List that apply to K43.1: 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.
- 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 incisional 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.
- 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 K43.1, its category, or a range that includes it.
Excludes1 1
These codes carry an Excludes1 note naming K43.1: 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.
Clinical ClassificationClinical
AHRQ’s CCSR groups this code into broader clinical categories.
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
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 K43.1 to ICD-9-CMHistory
The closest ICD-9-CM equivalents under the General Equivalence Mappings.
Code HistoryHistory
Questions About K43.1Overview
What is the ICD-10 code for incisional hernia with gangrene?
The ICD-10-CM code for incisional hernia with gangrene is K43.1 (sometimes written as K431). It is billable on HIPAA-covered claims from October 1, 2026 through September 30, 2027.
Is K43.1 (Ventral hernia) a billable code?
Yes. This is a billable ICD-10-CM code, specific enough to report incisional hernia with gangrene on HIPAA-covered claims from October 1, 2026 through September 30, 2027.
What MS-DRG does K43.1 group to?
When incisional 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 K43.1 a CC or MCC?
CMS lists K43.1 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.
What is the ICD-9 equivalent of K43.1?
Under the General Equivalence Mappings, incisional hernia with gangrene converts to ICD-9-CM 551.21 (gangr incisional hernia). The mapping is a direct match.
