2025 ICD-10-CM code K25.1
(Active) Effective Date: N/A Revision Date: N/A Diseases of the digestive system - Gastric ulcer XI Diseases of the digestive system Feed
Acute gastric ulcer with perforation.
Modifiers may be applicable depending on the circumstances of the treatment (e.g., surgical approach, anesthesia). Consult official coding guidelines for specific modifier applications.
Medical necessity for treatment of a perforated gastric ulcer is established by the presence of symptoms indicative of perforation (severe abdominal pain, peritonitis), confirmed by imaging studies.The condition requires urgent intervention to prevent sepsis and potential death.
The clinical responsibility involves prompt diagnosis and treatment of the perforated ulcer, often requiring surgery and post-operative care.
In simple words: This code describes a sudden and serious problem with a stomach ulcer. The ulcer has developed a hole in the stomach lining, which needs urgent medical care.
This code signifies an acute gastric ulcer that has perforated, meaning it has created a hole in the stomach wall.This is a serious condition requiring immediate medical attention.
Example 1: A 60-year-old male presents to the emergency room with severe abdominal pain, radiating to the back, after consuming alcohol.Physical exam reveals rigidity and rebound tenderness. A CT scan confirms a perforated gastric ulcer., A 45-year-old female with a history of NSAID use experiences sudden onset of intense upper abdominal pain and hypotension.Laparoscopic surgery confirms perforation of a gastric ulcer and requires surgical repair., A 72-year-old patient with a history of peptic ulcer disease is admitted with signs of peritonitis.An upper endoscopy reveals a perforated gastric ulcer, and emergency surgery is performed to repair the perforation and control bleeding.
Complete history and physical exam documenting the symptoms (abdominal pain, rigidity, rebound tenderness), laboratory results (complete blood count, electrolytes), imaging studies (CT scan, X-ray), operative notes (if surgery was performed), and pathology reports (if tissue samples were taken).Documentation must support medical necessity and the acuity of the situation.
** Always review the latest coding guidelines and payer-specific instructions for accurate billing.The severity and complexity of the case will influence the overall coding and billing process.
- Payment Status: Active
- Specialties:Gastroenterology, General Surgery
- Place of Service:Emergency Room - Hospital, Inpatient Hospital, Ambulatory Surgical Center