ICD Body System
Diseases of the digestive system [520 - 579]
Date amended:
External
Statements of Principles
Current RMA Instruments:

Reasonable Hypothesis SOP

91 of 2025

Balance of Probabilities SOP

92 of 2025
Changes from previous instruments
 
ICD Coding
  • ICD-10-AM Codes: K42
Brief description

An umbilical hernia is a protrusion of intra-abdominal tissue through a defect in the abdominal wall in the region of the umbilicus (belly button). This includes umbilical, peri-umbilical, and para-umbilical hernias. 

Umbilical hernias do not include incisional hernias that occur at the umbilicus following a previous surgical incision; these are covered separately under the incisional hernia SOP. 

Confirming the diagnosis

The diagnosis is based on the clinical history and physical examination, typically demonstrating a bulge at or around the umbilicus that may become more noticeable with coughing, straining, or standing. 

In most cases, general practitioners can confirm the diagnosis clinically. Imaging (usually ultrasound) may be arranged if the diagnosis is uncertain or if surgical management is being considered. General surgeons can become involved for further assessment and treatment. 

Additional diagnoses covered by SOP
  • Nil
Conditions not covered by SOP
  • Diastasis recti #
  • Epigastric hernia #
  • Femoral hernia #
  • Hiatus hernia *
  • Incisional hernia at or near the umbilicus *
  • Inguinal hernia *
  • Obturator hernia #

* another SOP applies 

# non-SOP condition

Clinical onset

Clinical onset refers to the earliest time at which the characteristic features of an umbilical, peri-umbilical or para-umbilical hernia were first present. The condition may be asymptomatic and discovered incidentally, but more commonly, a bulge near the umbilicus is noticed by the individual or their doctor. 

There may be mild discomfort when coughing, exercising, or during bowel movements, though hernias are rarely painful. Once the diagnosis is confirmed, onset may be backdated to when the bulge or symptoms were first observed. 

Clinical worsening

Umbilical hernias typically remain stable or progress slowly over time. Clinical worsening may be indicated by enlargement of the hernia, increasing symptoms, or the development of complications such as obstruction, incarceration, strangulation, or rarely, rupture. 

Management may be conservative or may require surgical repair, depending on the symptoms, size, and the presence of complications. Specialist surgical review is often required to consider whether any deterioration represents worsening beyond the expected natural course of the condition.