ICD-10 Coding for Peptic Ulcer(K25.0, K26.0)
Complete ICD-10-CM coding and documentation guide for Peptic Ulcer. Includes clinical validation requirements, documentation requirements, and coding pitfalls.
Also known as:
Related ICD-10 Code Ranges
Complete code families applicable to Peptic Ulcer
K25-K28Primary Range
Peptic ulcer diseases, including gastric, duodenal, and unspecified sites
These codes cover the primary classification of peptic ulcers based on 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 there is documented acute gastric ulcer with active bleeding. |
|
| K26.0 | Acute duodenal ulcer with hemorrhage | Use when there is documented acute duodenal ulcer with active bleeding. |
|
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 ulcer with hemorrhage
Essential facts and insights about Peptic Ulcer
Primary ICD-10-CM Codes for peptic ulcer
Decision Criteria
clinical Criteria
- Presence of active bleeding on endoscopy
Applicable To
- Acute gastric ulcer with bleeding
Excludes
- Chronic gastric ulcer with hemorrhage (K25.4)
Clinical Validation Requirements
- Endoscopy showing active bleeding
- Hemoglobin level indicating anemia
Code-Specific Risks
- Misclassification if chronicity is not specified
Coding Notes
- Ensure documentation specifies acute vs. chronic and presence of hemorrhage.
K26.0 - Acute duodenal ulcer with hemorrhage
Use when there is documented acute duodenal ulcer with active bleeding.
Applicable To
- Acute duodenal ulcer with bleeding
Excludes
- Chronic duodenal ulcer with hemorrhage (K26.4)
Clinical Validation Requirements
- Endoscopy confirming duodenal ulcer with bleeding
- Clinical signs of upper GI bleed
Coding Notes
Document ulcer site and confirm bleeding through diagnostic tests.
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 Ulcer 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 inadequate treatment., Regulatory: Non-compliance with coding standards., Financial: Potential loss of reimbursement for complications.
Mitigation Strategy
Ensure thorough documentation of endoscopy findings., Train staff on importance of detailed clinical notes.
Impact
Reimbursement: May lead to incorrect DRG assignment and affect payment., Compliance: Non-compliance with coding guidelines., Data Quality: Decreases accuracy of clinical data.
Mitigation Strategy
Ensure documentation specifies the ulcer site and use the appropriate code.
Impact
Inadequate documentation of complications can lead to audit issues.
Mitigation Strategy
Implement regular documentation audits and training.
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 Ulcer, with expert answers to help guide accurate code selection and documentation.
Documentation Templates for Peptic Ulcer
Use these documentation templates to ensure complete and accurate documentation for Peptic Ulcer. These templates include all required elements for proper coding and billing.
Acute duodenal ulcer with hemorrhage
Specialty: GastroenterologyRequired Elements
- Patient history of ulcer symptoms
- Endoscopy findings
- Hemoglobin levels
Example Documentation
Examples: Poor vs. Good Documentation
Poor Documentation Example
Good Documentation Example
Explanation
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