ICD-10 Coding for Peptic Disease(K25.0, K26.2)
Complete ICD-10-CM coding and documentation guide for Peptic Disease. Includes clinical validation requirements, documentation requirements, and coding pitfalls.
Also known as:
Related ICD-10 Code Ranges
Complete code families applicable to Peptic Disease
K25-K28Primary Range
Peptic ulcer disease codes, including gastric, duodenal, peptic unspecified, and gastrojejunal ulcers
This range covers all types of peptic ulcers, specifying location and complications.
Code Comparison: When to Use Each Code
Compare key differences between these codes to ensure accurate selection
| Code | Description | When to Use | Key Documentation |
|---|---|---|---|
| K25.0 | Acute gastric ulcer with hemorrhage | Use when an acute gastric ulcer is confirmed with active bleeding. |
|
| K26.2 | Acute duodenal ulcer with hemorrhage and perforation | Use when both hemorrhage and perforation are present in an acute duodenal ulcer. |
|
Clinical Decision Support
Always review the patient's clinical documentation thoroughly. When in doubt, choose the more specific code and ensure documentation supports it.
Key Information: ICD-10 code for peptic disease
Essential facts and insights about Peptic Disease
Primary ICD-10-CM Codes for peptic disease
Decision Criteria
clinical Criteria
- Presence of active bleeding in gastric ulcer
Applicable To
- Acute gastric ulcer with bleeding
Excludes
- Chronic gastric ulcer with hemorrhage (K25.4)
Clinical Validation Requirements
- EGD report showing active bleeding
- Hemoglobin <12 g/dL
Code-Specific Risks
- Ensure documentation specifies 'acute' and 'hemorrhage'.
Coding Notes
- Sequence ulcer code before alcohol-related codes.
K26.2 - Acute duodenal ulcer with hemorrhage and perforation
Use when both hemorrhage and perforation are present in an acute duodenal ulcer.
Applicable To
- Acute duodenal ulcer with bleeding and perforation
Excludes
- Chronic duodenal ulcer with hemorrhage (K26.4)
Clinical Validation Requirements
- Operative note confirming perforation
- Imaging showing free air
Coding Notes
Document both hemorrhage and perforation clearly.
Ancillary Codes
Additional codes that should be used in conjunction with the main diagnosis codes when applicable.
Documentation & Coding Risks
Avoid these common documentation and coding issues when documenting Peptic Disease to ensure proper reimbursement, maintain compliance, and reduce audit risk. These guidelines are particularly important when using ICD-10 code K25.0.
Impact
Clinical: May lead to misdiagnosis or inappropriate treatment., Regulatory: Non-compliance with documentation standards., Financial: Potential for claim denials.
Mitigation Strategy
Ensure detailed documentation of ulcer characteristics.
Impact
Reimbursement: May lead to claim denials., Compliance: Non-compliance with ICD-10 specificity requirements., Data Quality: Reduces accuracy of medical records.
Mitigation Strategy
Ensure documentation specifies ulcer location and complications.
Impact
Unspecified codes may trigger audits.
Mitigation Strategy
Always document specific ulcer characteristics.
Documentation errors, coding pitfalls, and audit risks are interconnected aspects of medical coding and billing. Addressing all three areas helps ensure accurate coding, optimal reimbursement, and regulatory compliance.
Frequently Asked Questions
Common questions about ICD-10 coding for Peptic Disease, with expert answers to help guide accurate code selection and documentation.
Documentation Templates for Peptic Disease
Use these documentation templates to ensure complete and accurate documentation for Peptic Disease. These templates include all required elements for proper coding and billing.
Acute gastric ulcer with hemorrhage
Specialty: GastroenterologyRequired Elements
- Ulcer location
- Acuity
- Complications
- Etiology
Example Documentation
Examples: Poor vs. Good Documentation
Poor Documentation Example
Good Documentation Example
Explanation
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