ICD-10 code for incisional hernia

The ICD-10-CM code for incisional hernia is K43.2 (Incisional hernia without obstruction or gangrene). The official index lists 2 more specific codes, so check the documentation for details such as type, cause, site or severity before settling on K43.2.

Within K43, choose K43.2 (Incisional hernia without obstruction or gangrene) only when documentation doesn't support a more specific option: incisional hernia with obstruction, without gangrene (K43.0), incisional hernia with gangrene (K43.1), Parastomal hernia with obstruction, without gangrene (K43.3), Parastomal hernia with gangrene (K43.4), Parastomal hernia without obstruction or gangrene (K43.5), other and unspecified ventral hernia with obstruction, without gangrene (K43.6), other and unspecified ventral hernia with gangrene (K43.7) and without obstruction or gangrene (K43.9).

It is not a CC or MCC, so as a secondary diagnosis it doesn't change the MS-DRG severity level.

In MS-DRG v44.0, it is part of the grouping logic for DRG 393 (Other Digestive System Diagnoses with MCC, relative weight 1.5881), DRG 394 (Other Digestive System Diagnoses with CC, relative weight 0.9228) and DRG 395 (Other Digestive System Diagnoses without CC/MCC, relative weight 0.6382), in MDC 06 (Diseases and Disorders of the Digestive System), as a principal or secondary diagnosis. The DRG a claim lands in depends on the principal diagnosis, procedures and any CC/MCC secondary diagnoses.