2025 ICD-10-CM code K26
(Active) Effective Date: N/A Revision Date: N/A Deletion Date: N/A Diseases of the esophagus, stomach, and duodenum - Duodenal ulcer Diseases of the digestive system Feed
Duodenal ulcer; includes acute erosion of the duodenum and peptic ulcer.
Modifiers might apply depending on the context (e.g., multiple ulcers or involvement of other anatomical areas).Appropriate modifier selection should be determined by the specific clinical scenario and payer guidelines.
Medical necessity for treatment of duodenal ulcers is established based on the presence of significant symptoms (e.g., severe pain, bleeding, perforation) that affect the patient's quality of life or pose a risk to their health.Treatment may include medication (PPIs, H2 blockers), dietary modifications, and in some cases, surgery.
Gastroenterology, General Surgery
In simple words: This code refers to a sore or ulcer in the first part of your small intestine, called the duodenum.It's a type of peptic ulcer and can be acute (new) or chronic (long-lasting).Additional information might be needed to describe other related health problems.
K26 encompasses duodenal ulcers, which are peptic ulcers specifically located in the duodenum (the first part of the small intestine).This code includes acute erosions and peptic ulcers in the postpyloric region.Additional codes are necessary to specify conditions like alcohol abuse or dependence which may be contributing factors.The code excludes peptic ulcers not otherwise specified (NOS).
Example 1: A 45-year-old male presents with epigastric pain radiating to the back, nausea, vomiting, and melena (dark, tarry stools). Endoscopy reveals a chronic duodenal ulcer with active bleeding. Code K26 is used to report the duodenal ulcer, with additional codes as needed to specify the bleeding complication., A 60-year-old female with a history of NSAID use complains of recurrent epigastric pain. Upper endoscopy confirms a duodenal ulcer without active bleeding. Code K26 is used, with additional codes to specify the chronic nature of the ulcer if necessary and potentially adding a code for the history of NSAID use., A 30-year-old male experiencing severe, sudden epigastric pain and hematemesis (vomiting blood) is diagnosed with an acute, perforated duodenal ulcer requiring emergency surgery. Code K26 is applied, along with codes specifying the perforation and surgical intervention.
Detailed history of symptoms (including onset, duration, character, location, and radiation of pain), physical examination findings (abdominal tenderness, guarding, rigidity), laboratory results (CBC, blood type and crossmatch if bleeding is significant), endoscopic findings (location, size, and characteristics of the ulcer, presence or absence of bleeding or perforation), and any imaging studies performed (upper endoscopy, abdominal x-rays, CT scan).
** Always cross-reference K26 with additional codes to fully capture the clinical picture, including any complications (bleeding, perforation), associated conditions (H. pylori infection), and treatment provided.Specific subcodes under K26 (such as K26.0-K26.9) should be used when more precise information is available.
- Payment Status: Active
- Modifier TC rule: Not applicable for K26, as this is a diagnosis code, not a procedure code.
- Specialties:Gastroenterology, General Surgery
- Place of Service:Office, Hospital (Inpatient and Outpatient), Ambulatory Surgical Center, Emergency Room