K43
Non-Billable

Ventral hernia

Non-Billable / Non-Specific Code

What is Ventral hernia?

ICD-10-CM K43 is the diagnosis code for Ventral hernia. This code falls under the section "Hernia" within Chapter 11 — Diseases of the digestive system (K00-K95). It is a non-billable/non-specific ICD-10-CM code that should not be used for reimbursement. A more specific sub-code is required for billing. Medical coders and healthcare providers use this code to document and classify diagnoses in electronic health records, insurance claims, and clinical databases.

Coding Guidelines for K43

Always refer to the official ICD-10-CM Tabular List for complete coding guidelines. Ensure documentation supports the specificity of the code selected. When in doubt, consult a certified medical coder or the latest CMS guidelines.

ICD-10-CM Code Hierarchy

Understanding where K43 sits in the ICD-10-CM classification helps ensure proper coding:

Sub-Codes 9 entries
K43.0Incisional hernia with obstruction, without gangreneBillableK43.1Incisional hernia with gangreneBillableK43.2Incisional hernia without obstruction or gangreneBillableK43.3Parastomal hernia with obstruction, without gangreneBillableK43.4Parastomal hernia with gangreneBillableK43.5Parastomal hernia without obstruction or gangreneBillableK43.6Other and unspecified ventral hernia with obstruction, without gangreneBillableK43.7Other and unspecified ventral hernia with gangreneBillableK43.9Ventral hernia without obstruction or gangreneBillable
Related Codes

Frequently Asked Questions

Is K43 a billable ICD-10-CM code?

No, K43 is a non-billable/non-specific code. You should use a more specific sub-code for billing and reimbursement.

What does K43 mean?

K43 is the ICD-10-CM diagnosis code for "Ventral hernia". It is used by healthcare providers to classify and document this condition in medical records and insurance claims.

What section is K43 in?

K43 is located in Section K40-K46 — "Hernia" within Chapter 11 of the ICD-10-CM Tabular List.

What are the sub-codes of K43?

K43 has 9 sub-code(s) that provide more specific detail: K43.0, K43.1, K43.2, K43.3, K43.4 and more.

When should I use K43?

Use K43 when the patients documented diagnosis matches "Ventral hernia" and the clinical documentation supports this level of specificity. Always verify with the latest ICD-10-CM guidelines and payer requirements.

People Also Ask

What is the ICD-10 code for Ventral hernia?

The ICD-10-CM code for Ventral hernia is K43.

Can K43 be used for primary diagnosis?

No, K43 is non-billable. Use a more specific sub-code for primary diagnosis billing.

What chapter is K43 in?

K43 is in Chapter 11 of the ICD-10-CM Tabular List.

Is K43 valid for 2026?

Yes, K43 is a valid ICD-10-CM code for the 2026 fiscal year, subject to official CMS updates.

See Also

← PreviousK42.9Umbilical hernia without obstruction or gangreneNext →K43.0Incisional hernia with obstruction, without gangrene
Code Details
K43
Ventral hernia
Non-Billable / Non-Specific Code
11 — Diseases of the digestive system (K00-K95)
K40-K46 — Hernia
2026 ICD-10-CM