2027 ICD-10-CM Diagnosis Code K43.6Other and unspecified ventral hernia with obstruction, without gangrene
ICD-10-CM Codes›K00–K95›K40-K46›K43
- Billable — Valid for Submission
- CC — Complication or Comorbidity
- Not Chronic
K43.6 is a billable ICD-10-CM diagnosis code for other and unspecified ventral 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 epigastric 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.
- Epigastric hernia
- Irreducible epigastric hernia
- Irreducible Spigelian hernia
- Obstructed epigastric hernia
- Obstructed Spigelian hernia
- Spigelian hernia
- Strangulated epigastric hernia
- Strangulated hernia of anterior abdominal wall
Instructional NotesGuidance
Instructions from the official ICD-10-CM Tabular List that apply to K43.6: 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.
- Epigastric hernia causing obstruction, without gangrene
- Hypogastric hernia causing obstruction, without gangrene
- Incarcerated epigastric hernia without gangrene
- Incarcerated hypogastric hernia without gangrene
- Incarcerated midline hernia without gangrene
- Incarcerated spigelian hernia without gangrene
- Incarcerated subxiphoid hernia without gangrene
- Irreducible epigastric hernia without gangrene
- Irreducible hypogastric hernia without gangrene
- Irreducible midline hernia without gangrene
- Irreducible spigelian hernia without gangrene
- Irreducible subxiphoid hernia without gangrene
- Midline hernia causing obstruction, without gangrene
- Spigelian hernia causing obstruction, without gangrene
- Strangulated epigastric hernia without gangrene
- Strangulated hypogastric hernia without gangrene
- Strangulated midline hernia without gangrene
- Strangulated spigelian hernia without gangrene
- Strangulated subxiphoid hernia without gangrene
- Subxiphoid hernia causing obstruction, without gangrene
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 K43.6, its category, or a range that includes it.
Applicable To 1
These notes mention K43.6.
- K43.7 Other and unspecified ventral hernia with gangreneAny condition listed under K43.6 specified as gangrenous
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
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
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Convert K43.6 to ICD-9-CMHistory
Code HistoryHistory
Questions About K43.6Overview
Is K43.6 (Ventral hernia) a billable code?
Yes. This is a billable ICD-10-CM code, specific enough to report other and unspecified ventral hernia with obstruction, without gangrene on HIPAA-covered claims from October 1, 2026 through September 30, 2027.
What MS-DRG does K43.6 group to?
When other and unspecified ventral 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 K43.6 a CC or MCC?
CMS lists K43.6 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.
What is the ICD-9 equivalent of K43.6?
Under the General Equivalence Mappings, other and unspecified ventral hernia with obstruction, without gangrene converts to ICD-9-CM 552.20 (obstr ventral hernia NOS) and 552.29 (obstr ventral hernia NEC). The mapping is approximate, so confirm the match fits the documentation.
