ICD-10 · PDGM grouping
K43 Ventral hernia
All 9 codes in the K43 family, with the PDGM clinical group, comorbidity subgroup and primary-position rule CMS assigns, read from the CMS grouper crosswalk v07.2.26 and the CDC FY2027 code file.
Codes in family
9
Can lead a claim
9
Cannot lead a claim
0
What CMS assigns to K43
All 9 codes group to MMTA - Gastrointestinal tract and Genitourinary system. None of the 9 is assigned a comorbidity subgroup. Every code can lead a claim.
Every code in K43
Descriptions are CDC’s FY2027 wording; where CMS’s grouper abbreviates one, its form is shown beneath.
| Code | Description | Primary position | Clinical group | Comorbidity subgroup |
|---|---|---|---|---|
| K43.0 | Incisional hernia with obstruction, without gangrene | Can lead a claim | J | None |
| K43.1 | Incisional hernia with gangrene | Can lead a claim | J | None |
| K43.2 | Incisional hernia without obstruction or gangrene | Can lead a claim | J | None |
| K43.3 | Parastomal hernia with obstruction, without gangrene | Can lead a claim | J | None |
| K43.4 | Parastomal hernia with gangrene | Can lead a claim | J | None |
| K43.5 | Parastomal hernia without obstruction or gangrene | Can lead a claim | J | None |
| K43.6 | Other and unspecified ventral hernia with obstruction, without gangreneCMS: Other and unsp ventral hernia with obstruction, w/o gangrene | Can lead a claim | J | None |
| K43.7 | Other and unspecified ventral hernia with gangrene | Can lead a claim | J | None |
| K43.9 | Ventral hernia without obstruction or gangrene | Can lead a claim | J | None |
Sources: CMS HH PPS Grouper Software v07.2.26, effective 2026-10-01, for the clinical group, comorbidity subgroup, code-first conventions and primary-position flags; CDC NCHS ICD-10-CM FY2027 code descriptions for the family title and code wording. This is the crosswalk Medicare runs a claim through. Grouping also depends on admission source, timing, the OASIS functional items and the rest of the diagnosis list.
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