ICD-10 · PDGM grouping
K40-K46 — Hernia
Every ICD-10-CM code in this range and the PDGM clinical group CMS assigns to it, read from the CMS grouper crosswalk v07.2.26.
Codes in range
45
No clinical group
2
A period cannot be grouped from these.
Barred as primary
0
CMS rejects these in the primary position.
Where these codes group
32 of the 45 codes in K40-K46 group to MMTA - Gastrointestinal tract and Genitourinary system, but the range is not uniform — it spreads across 2 clinical groups. A further 2 are assigned no clinical group at all, which means a 30-day period cannot be grouped from them.
Code families in K40-K46
One page per three-character family: every code in it, whether it can lead a claim, its clinical group and comorbidity subgroup.
Every code in K40-K46
Descriptions are CMS’s own, abbreviated as CMS abbreviates them.
| Code | Description | Clinical group | Primary position |
|---|---|---|---|
| K4000 | Bi inguinal hernia, w obst, w/o gangrene, not spcf as recur | J | Can lead a claim |
| K4001 | Bilateral inguinal hernia, w obst, w/o gangrene, recurrent | J | Can lead a claim |
| K4010 | Bi inguinal hernia, w gangrene, not specified as recurrent | A | Can lead a claim |
| K4011 | Bilateral inguinal hernia, with gangrene, recurrent | A | Can lead a claim |
| K4020 | Bi inguinal hernia, w/o obst or gangrene, not spcf as recur | J | Can lead a claim |
| K4021 | Bilateral inguinal hernia, w/o obst or gangrene, recurrent | J | Can lead a claim |
| K4030 | Unil inguinal hernia, w obst, w/o gangr, not spcf as recur | J | Can lead a claim |
| K4031 | Unilateral inguinal hernia, w obst, w/o gangrene, recurrent | J | Can lead a claim |
| K4040 | Unil inguinal hernia, w gangrene, not specified as recurrent | J | Can lead a claim |
| K4041 | Unilateral inguinal hernia, with gangrene, recurrent | A | Can lead a claim |
| K4090 | Unil inguinal hernia, w/o obst or gangr, not spcf as recur | J | Can lead a claim |
| K4091 | Unilateral inguinal hernia, w/o obst or gangrene, recurrent | J | Can lead a claim |
| K4100 | Bi femoral hernia, w obst, w/o gangrene, not spcf as recur | A | Can lead a claim |
| K4101 | Bilateral femoral hernia, w obst, w/o gangrene, recurrent | A | Can lead a claim |
| K4110 | Bi femoral hernia, w gangrene, not specified as recurrent | A | Can lead a claim |
| K4111 | Bilateral femoral hernia, with gangrene, recurrent | A | Can lead a claim |
| K4120 | Bi femoral hernia, w/o obst or gangrene, not spcf as recur | A | Can lead a claim |
| K4121 | Bilateral femoral hernia, w/o obst or gangrene, recurrent | A | Can lead a claim |
| K4130 | Unil femoral hernia, w obst, w/o gangrene, not spcf as recur | J | Can lead a claim |
| K4131 | Unilateral femoral hernia, w obst, w/o gangrene, recurrent | J | Can lead a claim |
| K4140 | Unil femoral hernia, w gangrene, not specified as recurrent | J | Can lead a claim |
| K4141 | Unilateral femoral hernia, with gangrene, recurrent | A | Can lead a claim |
| K4190 | Unil femoral hernia, w/o obst or gangrene, not spcf as recur | J | Can lead a claim |
| K4191 | Unilateral femoral hernia, w/o obst or gangrene, recurrent | J | Can lead a claim |
| K420 | Umbilical hernia with obstruction, without gangrene | J | Can lead a claim |
| K421 | Umbilical hernia with gangrene | J | Can lead a claim |
| K429 | Umbilical hernia without obstruction or gangrene | J | Can lead a claim |
| K430 | Incisional hernia with obstruction, without gangrene | J | Can lead a claim |
| K431 | Incisional hernia with gangrene | J | Can lead a claim |
| K432 | Incisional hernia without obstruction or gangrene | J | Can lead a claim |
| K433 | Parastomal hernia with obstruction, without gangrene | J | Can lead a claim |
| K434 | Parastomal hernia with gangrene | J | Can lead a claim |
| K435 | Parastomal hernia without obstruction or gangrene | J | Can lead a claim |
| K436 | Other and unsp ventral hernia with obstruction, w/o gangrene | J | Can lead a claim |
| K437 | Other and unspecified ventral hernia with gangrene | J | Can lead a claim |
| K439 | Ventral hernia without obstruction or gangrene | J | Can lead a claim |
| K440 | Diaphragmatic hernia with obstruction, without gangrene | J | Can lead a claim |
| K441 | Diaphragmatic hernia with gangrene | J | Can lead a claim |
| K449 | Diaphragmatic hernia without obstruction or gangrene | J | Can lead a claim |
| K450 | Oth abdominal hernia with obstruction, without gangrene | J | Can lead a claim |
| K451 | Other specified abdominal hernia with gangrene | A | Can lead a claim |
| K458 | Oth abdominal hernia without obstruction or gangrene | J | Can lead a claim |
| K460 | Unsp abdominal hernia with obstruction, without gangrene | J | Can lead a claim |
| K461 | Unspecified abdominal hernia with gangrene | None | Cannot lead a claim |
| K469 | Unspecified abdominal hernia without obstruction or gangrene | None | Cannot lead a claim |
Source: CMS HH PPS Grouper Software v07.2.26, effective 2026-10-01. 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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