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K44.1 ICD-10-CM Code: Diaphragmatic hernia with gangrene

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Billing Status: YES. This is a valid, specific, and billable ICD-10-CM reference.

Coding at a Glance

Tabular directives
6 inclusion terms · 2 Excludes1

Billable · FY2027A valid, specific ICD-10-CM code, reportable for dates of service in FY2027.

What you need to know

Source: CMS/NCHS Official ICD-10-CM tabular notes, quoted. From the CMS/NCHS tabular list for the release in force. A note the category or block publishes applies to this code too; the Instructions section marks which is which.

Excludes1Never report with this code
  • congenital diaphragmatic hernia (Q79.0)
  • congenital hiatus hernia (Q40.1)
IncludesWhat this code covers
  • hiatus hernia (esophageal) (sliding)
  • paraesophageal hernia
  • acquired hernia
  • congenital [except diaphragmatic or hiatus] hernia

+2 more in Instructions

Most relevant related codes MedCoder-derived

Read off the official notes above and this code’s own position in the tabular list. Which to report is a documentation question; Compare shows the two side by side.

CompareCheck ClaimView Related Codes

Inpatient Payment Groups (MS-DRG)

Potential MS-DRG participation — not a DRG assignment.

MS-DRGs this diagnosis helps define, as principal or secondary, per the CMS ICD-10-CM/PCS MS-DRG Definitions Manual v44, Appendix B.

  • MS-DRG 393 — OTHER DIGESTIVE SYSTEM DIAGNOSES WITH MCC (MDC 06)
  • MS-DRG 394 — OTHER DIGESTIVE SYSTEM DIAGNOSES WITH CC (MDC 06)
  • MS-DRG 395 — OTHER DIGESTIVE SYSTEM DIAGNOSES WITHOUT CC/MCC (MDC 06)
  • MS-DRG 791 — PREMATURITY WITH MAJOR PROBLEMS (MDC 15)
  • MS-DRG 793 — FULL TERM NEONATE WITH MAJOR PROBLEMS (MDC 15)

A diagnosis appearing in a group's logic does not by itself determine the DRG assigned to a stay; the grouper uses the full claim.

Coding instructions

Official Tabular Instructional Notes: the inclusion, exclusion and sequencing notes published for K44.1 in the official ICD-10-CM tabular list, quoted as published.

Source: CMS/CDC — ICD-10-CM Tabular ListRelease: FY2027Effective: October 1, 2026

Trace:FY2027 changesChange historyRelease, file and checksum

Notes without a marker are published on K44.1 itself; “inherited from” names the category or block whose note applies here.

Includes

Conditions the official ICD-10-CM tabular list includes under this code.

  • hiatus hernia (esophageal) (sliding) inherited from K44
  • paraesophageal hernia inherited from K44
  • acquired hernia inherited from K40-K46
  • congenital [except diaphragmatic or hiatus] hernia inherited from K40-K46
  • recurrent hernia inherited from K40-K46

Inclusion Terms

Alternative terms the tabular list files under this code.

  • Gangrenous diaphragmatic hernia

Excludes1 — Not Coded Here

Conditions generally not reported together with this code (Excludes1) -- an error unless the two conditions are documented as unrelated to each other (ICD-10-CM Official Guidelines, Section I.A.12.a).

Source: inherited from K44

Coder workflow for K44.1

MedCoder structured workflow — derived from this code’s own official record

Before you code K44.1

  1. K44.1’s title joins a condition with an associated condition or complication. Confirm each component is documented. Where the classification presumes the link through the “with” convention, only a provider statement that the conditions are unrelated defeats it. A combination code is assigned only when it fully identifies the documented conditions; a required second code for the stage, type or manifestation is still reported when the notes ask for it (Guidelines I.B.9, I.A.15).

    Guide: Combination codes →

  2. Check the Excludes1 note: if the documentation supports a condition named there, do not simply proceed with K44.1. Excludes1 conditions are not reported together with this code unless the record shows they are unrelated (Guidelines I.A.12.a).

    See the official tabular notes

Choose the right path

  1. Does the documentation support a condition named in K44.1’s Excludes1 note?
    Yes → Do not simply proceed: review the excluded code. Both are reported only when the record shows the two conditions are unrelated.
    No → Continue.

    ReviewQ79.0, Q40.1

Consider K44.1. Then confirm the code is valid for the date of service in the Verify section.

Documentation check

The provider’s diagnostic statement
Codes are assigned from the provider’s documented diagnosis, not from clinical criteria, test values or a medication list (Guidelines I.A.19).
The associated condition or complication
Whether the associated condition the title names is documented; the “with” convention presumes some links, and a provider statement that the conditions are unrelated defeats it (Guidelines I.A.15).

Official instructions as workflow

  • Excludes1 — check before selecting K44.1(2 notes)

    Coding workflow: If the documentation supports a condition named in this note, do not simply proceed with K44.1: the two are not reported together. The one exception is when the record shows the two conditions are unrelated to each other.

    CompareQ79.0, Q40.1

    See the official tabular notes · Guidelines I.A.12.a

Coding decision scenarios

Pattern scenarios for this code’s structure — decision rules, not clinical cases

Documentation: Both the condition K44.1 describes and a condition named in its Excludes1 note are documented for the same encounter.

Coding question: Can both codes be reported?

Path: Review the Excludes1 note and the excluded code, and look for a provider statement on whether the two conditions are related.

Reason: Excludes1 means the two are not coded together; the exception is when the record shows the conditions are unrelated to each other (Guidelines I.A.12.a).

ReviewQ79.0, Q40.1

Documentation: Only one of the components this code’s title joins is documented.

Coding question: Is K44.1 supported?

Path: Review the code for the documented component on its own.

Reason: A combination code is assigned only when it fully identifies the documented conditions; otherwise the documented component takes its own code (Guidelines I.B.9).

Every row is derived from this code’s own record — its title, tabular notes, 7th-character family and same-category siblings — with fixed MedCoder wording; nothing is inferred about a patient. The official notes and guideline text are in the sections each row links to, and they control.

Don’t confuse K44.1 with…

MedCoder analysis — pairs from this code’s official notes, distinctions written by MedCoder

The codes most likely to be picked instead of K44.1 — named in its own official notes, or sharing its laterality or encounter family — with what separates them and which documentation moves the case. Each links to the full comparison.

  • Q79.0— Excludes1 conflict (Excludes1 — generally not reported together)

    Not coded here — the tabular list excludes this pair for the same encounter.

    Not reported together with this code, except where the two conditions are documented as unrelated.

    What moves you there: Documentation of congenital diaphragmatic hernia moves the case to Q79.0; the two are not reported together unless documented as unrelated.

    Full comparison: K44.1 vs Q79.0 →

  • Q40.1— Excludes1 conflict (Excludes1 — generally not reported together)

    Not coded here — the tabular list excludes this pair for the same encounter.

    Not reported together with this code, except where the two conditions are documented as unrelated.

    What moves you there: Documentation of congenital hiatus hernia moves the case to Q40.1; the two are not reported together unless documented as unrelated.

    Full comparison: K44.1 vs Q40.1 →

Relationships are read from this code's own official notes, its laterality siblings and its encounter family; the wording of each distinction is MedCoder editorial, and the documentation named in each “what moves you there” line is the official note phrase or sibling title itself. Source: CMS ICD-10-CM tabular instructional notes; ICD-10-CM Official Guidelines, Section I.A.12.a.

Coding context

Guidelines, coding notes, decision aids, relationships (with MS-DRG and CCSR classification), hierarchy, HCC, coverage and the context map: what a coder reaches for after the core. Each section names whether it is official source data, a MedCoder-derived relationship or MedCoder editorial.

Code Overview

Diaphragmatic hernia with gangrene is a billable ICD-10-CM diagnosis code (K44.1).

MedCoder summary Summary composed by MedCoder from this code's official ICD-10-CM record. The tabular instructional notes themselves appear verbatim below.

Official Coding Guidelines

No excerpt in the ICD-10-CM Official Guidelines names this code specifically. Its chapter carries only this chapter-wide note:

Chapter 11: Diseases of the Digestive System (K00-K95)

Reserved for future guideline expansion

Verify Before Coding

  • MCC as a secondary diagnosis (FY2027). Can raise the stay's MS-DRG severity tier.

From the code registry, the Medicare Code Editor, and the MS-DRG Definitions Manual. Check it against a full claim in Claim Check.

Relationships & Classification

MedCoder-derived relationships — computed from published CMS and AHRQ datasets

Other codes that name K44.1 or its code family, from the CMS ICD-10-CM tabular instructional notes. Tabular-note edges are stored at the code family level that carries each note.

Referenced by 1 Excludes1 note: I96 — Gangrene, not elsewhere classified.

These codes’ tabular lists mark this diagnosis as mutually exclusive — not reported together unless the conditions are documented as unrelated.

Referenced by 14 Excludes2 notes across 2 chapters: J98.6 — Disorders of diaphragm (via K44.-), K20 — Esophagitis (via K44.-), K20-K31 — Diseases of esophagus, stomach and duodenum (K20-K31) (via K44.-), K21 — Gastro-esophageal reflux disease (via K44.-), K22 — Other diseases of esophagus (via K44.-), K23 — Disorders of esophagus in diseases classified elsewhere (via K44.-), K25 — Gastric ulcer (via K44.-), K26 — Duodenal ulcer (via K44.-), K27 — Peptic ulcer, site unspecified (via K44.-), K28 — Gastrojejunal ulcer (via K44.-), K29 — Gastritis and duodenitis (via K44.-), K30 — Functional dyspepsia (via K44.-), K31 — Other diseases of stomach and duodenum (via K44.-), K56.7 — Ileus, unspecified (via K44.-).

These codes’ tabular lists name this diagnosis as distinct — both may be reported when both are documented.

MS-DRG Grouper Relationships (FY2027)

Potential MS-DRG participation — not a DRG assignment.

FY2027 MS-DRG: MCC — Major Complication or Comorbidity. Reported as a secondary diagnosis, this code raises the stay's MS-DRG severity tier — except when the principal diagnosis is one of 6 clinically related codes on its CMS exclusion list.

Named in the grouper logic of 5 MS-DRGs: DRG 393 (MDC 06), DRG 394 (MDC 06), DRG 395 (MDC 06), DRG 791 (MDC 15), DRG 793 (MDC 15).

From the CMS MS-DRG Definitions Manual (Appendices B and C). Actual DRG assignment depends on the complete claim.

Clinical classification (AHRQ CCSR):DIG010 — Abdominal hernia (default); CIR028 — Gangrene.

Clinical Classifications Software Refined (CCSR) for ICD-10-CM Diagnoses. Healthcare Cost and Utilization Project (HCUP), Agency for Healthcare Research and Quality.

Related Codes

Same clinical process (MS-DRG)

Acts as MCC — raises the severity of other admissions. CMS groups these diagnoses into one MS-DRG principal-diagnosis exclusion process — a CC/MCC on this list never raises severity when the principal diagnosis is also on it.

K44.0 — Diaphragmatic hernia with obstruction, without gangrene, K44.9 — Diaphragmatic hernia without obstruction or gangrene, K45.0 — Other specified abdominal hernia with obstruction, without gangrene, K45.8 — Other specified abdominal hernia without obstruction or gangrene, K46.0 — Unspecified abdominal hernia with obstruction, without gangrene

Same clinical category (CCSR)

AHRQ's Clinical Classifications Software groups these diagnoses under the same clinical categories (Abdominal hernia, Gangrene).

K42.9 — Umbilical hernia without obstruction or gangrene, K43.0 — Incisional hernia with obstruction, without gangrene, K43.1 — Incisional hernia with gangrene, K43.2 — Incisional hernia without obstruction or gangrene, K43.3 — Parastomal hernia with obstruction, without gangrene, K43.4 — Parastomal hernia with gangrene, K43.5 — Parastomal hernia without obstruction or gangrene, K43.6 — Other and unspecified ventral hernia with obstruction, without gangrene, K43.7 — Other and unspecified ventral hernia with gangrene, K43.9 — Ventral hernia without obstruction or gangrene, K44.0 — Diaphragmatic hernia with obstruction, without gangrene, K44.9 — Diaphragmatic hernia without obstruction or gangrene, K45.0 — Other specified abdominal hernia with obstruction, without gangrene, K45.1 — Other specified abdominal hernia with gangrene, K45.8 — Other specified abdominal hernia without obstruction or gangrene, K46.0 — Unspecified abdominal hernia with obstruction, without gangrene, K46.1 — Unspecified abdominal hernia with gangrene, K46.9 — Unspecified abdominal hernia without obstruction or gangrene, K82.A1 — Gangrene of gallbladder in cholecystitis, N49.3 — Fournier gangrene, +64 more

Same Index main term, other category

The ICD-10-CM Index to Diseases and Injuries files this code under the main term “Hernia, hernial”; these codes share that main term but sit in a different category of the Tabular List.

K42.9 — Umbilical hernia without obstruction or gangrene (umbilicus, umbilical), K43.0 — Incisional hernia with obstruction, without gangrene (incisional, with, obstruction), K43.1 — Incisional hernia with gangrene (incisional, with, gangrene), K43.2 — Incisional hernia without obstruction or gangrene (incisional), K43.3 — Parastomal hernia with obstruction, without gangrene (parastomal, with, obstruction), K43.4 — Parastomal hernia with gangrene (parastomal, with, gangrene), K43.5 — Parastomal hernia without obstruction or gangrene (parastomal), K43.6 — Other and unspecified ventral hernia with obstruction, without gangrene (ventral, with, obstruction), K43.7 — Other and unspecified ventral hernia with gangrene (ventral, with, gangrene), K43.9 — Ventral hernia without obstruction or gangrene (ventral), K45.0 — Other specified abdominal hernia with obstruction, without gangrene (abdomen, abdominal, specified site NEC, with, obstruction), K45.1 — Other specified abdominal hernia with gangrene (abdomen, abdominal, specified site NEC, with, gangrene), K45.8 — Other specified abdominal hernia without obstruction or gangrene (abdomen, abdominal, specified site NEC), K46.0 — Unspecified abdominal hernia with obstruction, without gangrene (abdomen, abdominal, with, obstruction), K46.1 — Unspecified abdominal hernia with gangrene (abdomen, abdominal, with, gangrene), K46.9 — Unspecified abdominal hernia without obstruction or gangrene, K56.50 — Intestinal adhesions [bands], unspecified as to partial versus complete obstruction (due to adhesions), M62.89 — Other specified disorders of muscle (fascia), N28.89 — Other specified disorders of kidney and ureter (ureter), N32.89 — Other specified disorders of bladder (prevesical), +39 more

Contextual Map

Every relationship of K44.1 in one view: hierarchy, official tabular instructions in both directions, clinical classification, risk adjustment, MS-DRG participation, index terms and change history — each edge carrying the CMS source it derives from.

Run K44.1 with these 9 related codes in Claim Check

Hierarchy

Referenced by Excludes1 notes

Referenced by Excludes2 notes (14)

Clinical classification (CCSR)

MS-DRG Grouper

MDC crossing

  • MDC 06 — Diseases and Disorders of the Digestive System[MDC crossing]: “Diseases and Disorders of the Digestive System — the grouper's crossing between diagnoses and procedures: a principal diagnosis sets the MDC, and same-MDC procedures move the stay to its surgical DRGs. 5,748 same-MDC procedures group here; browse them on the MDC page.”— CMS MS-DRG Definitions Manual · FY2027
  • MDC 15 — Newborns and Other Neonates with Conditions Originating in Perinatal Period[MDC crossing]: “Newborns and Other Neonates with Conditions Originating in Perinatal Period — the grouper's crossing between diagnoses and procedures: a principal diagnosis sets the MDC, and same-MDC procedures move the stay to its surgical DRGs.”— CMS MS-DRG Definitions Manual · FY2027

Index entries

  • Hernia, hernial (acquired) (recurrent), diaphragm, diaphragmatic, with, gangrene (and obstruction)[Index term]— CMS ICD-10-CM Index to Diseases and Injuries · icd10cm-fy2027
  • Hernia, hernial (acquired) (recurrent), hiatal (esophageal) (sliding), with, gangrene (and obstruction)[Index term]— CMS ICD-10-CM Index to Diseases and Injuries · icd10cm-fy2027

Nearest codes

Change history

  • FY2016 — In the code set at ICD-10-CM adoption [Change history]— CMS release files (code change ledger) · icd10cm-fy2016

Reference

Index terms and tables, published questions and FAQ, every source behind this page with its release and checksum, the date-of-service check and the complete change history.

Indexed Clinical Terms (2)

Official source data — entries quoted as published, in the Index’s own lookup phrasing

Clinical term phrases from the official ICD-10-CM Index to Diseases and Injuries that map to this code. These are alphabetic-index entries shown as the Index writes them — lookup phrasing, not necessarily the wording of a final diagnosis.

Sources for this page

Codes, titles, notes, index terms and mappings on this page are transcribed from the datasets below. Relationships MedCoder computed and text MedCoder wrote are labelled where they appear.

Code, title, tabular notes and index terms Official source data
CMS/CDC ICD-10-CM FY2027 tabular list, index and tables, effective October 1, 2026 Release, file and checksum · Publisher’s page
Coding guidelines Official source data
ICD-10-CM Official Guidelines for Coding and Reporting (FY2027), quoted by section Release, file and checksum · Publisher’s page
Claim edits Official source data
CMS Definitions of Medicare Code Edits — v44.0 (October 2026) Release, file and checksum · Publisher’s page
Inpatient payment groups Official source data
CMS MS-DRG Definitions Manual (incl. Appendix B diagnosis index, Appendix C CC/MCC list, Appendix E procedure index) and IPPS Final Rule tables — v44 Release, file and checksum · Publisher’s page
Change history and date-of-service validity Official source data
CMS ICD-10-CM release addenda, ingested release by release into the change ledger Release, file and checksum · Publisher’s page
Comparisons, relationships and the contextual map MedCoder-derived relationship
Computed by MedCoder from the tabular notes and tables above; every derived relationship is marked as derived where it appears
Summary and FAQ answers MedCoder editorial explanation
Written by MedCoder to explain the sources above: drafted with AI assistance, checked by a person against the release files, and labelled as MedCoder text where it appears. Not official text.

Current data releases:ICD-10-CM FY2027 · ICD-10-PCS FY2027 · HCPCS October 2026 · MS-DRG v44 · Medicare Code Editor v44.0 · NCCI PTP Q4 2026 · MUE Q4 2026 · NCD code lists 2026-01 · LCD export September 20, 2026 · All releases and sources

Labels on this page: Official source data · MedCoder-derived relationship · MedCoder editorial explanation. How to read the labels · All data sources and release dates · CMS coding rules

Cite this page

Reference this page in a research guide, syllabus or article. The release is included because code content changes each year.

MedCoder.ai. "K44.1 — Diaphragmatic hernia with gangrene." ICD-10-CM FY2027. https://medcoder.ai/icd10/code/k44.1-diaphragmatic-hernia-with-gangrene

Change history

  • FY2016 — October 1, 2015
    In the code set at ICD-10-CM adoption
    Diaphragmatic hernia with gangrene

No changes since FY2016 — additions, deletions, description changes and billable-status changes are tracked through FY2027, and none are recorded for this code. Note changes are tracked from FY2027 only.

Nearest Codes in This Family

Official ICD-10-CM classifications closest to K44.1 in its code family, with their registry titles.

View all codes in the K44 family