2025 ICD-10-CM code K26.4
Chronic or unspecified duodenal ulcer with hemorrhage.This code signifies a long-standing or undefined ulcer in the duodenum, accompanied by bleeding.
Medical necessity for services related to K26.4 is established by the presence of signs and symptoms of a bleeding duodenal ulcer, such as abdominal pain, gastrointestinal bleeding, or anemia.Diagnostic testing, such as endoscopy, is necessary to confirm the diagnosis and assess the severity of the bleeding.Treatment, including medications to reduce acid production, promote healing, and manage bleeding, is medically necessary to prevent complications such as perforation, peritonitis, and hypovolemic shock.
Clinicians responsible for diagnosing and managing K26.4 include gastroenterologists, primary care physicians, and possibly surgeons depending on the severity of the hemorrhage.Responsibilities include evaluating the patient's symptoms, ordering appropriate diagnostic tests (such as endoscopy), prescribing medications to reduce acid production and promote healing, and monitoring for complications like perforation or persistent bleeding.In severe cases, they may consult with surgeons for possible surgical intervention.
In simple words: A chronic or unspecified ulcer in the first part of the small intestine (duodenum) with bleeding.
A chronic (long-standing) or unspecified duodenal ulcer characterized by the presence of hemorrhage (bleeding).A duodenal ulcer is a break in the lining of the duodenum, the first part of the small intestine.The ulcer is classified as chronic if it has been present for a prolonged period or unspecified if the duration is unknown.
Example 1: A 55-year-old male presents with abdominal pain, melena (black, tarry stools), and a history of intermittent epigastric discomfort.Endoscopy reveals a chronic duodenal ulcer with active bleeding, which is treated with endoscopic hemostasis.The diagnosis is K26.4., A 70-year-old female with a history of peptic ulcer disease is admitted to the hospital with hematemesis (vomiting blood).Imaging and endoscopy confirm a bleeding duodenal ulcer of unspecified duration.She is stabilized with fluids and blood transfusions and started on medication to manage the ulcer.The diagnosis is K26.4., A 30-year-old female is diagnosed with a duodenal ulcer and experiences sudden onset of severe abdominal pain.She undergoes emergency surgery and is found to have a perforated duodenal ulcer with associated bleeding. Although perforation is treated surgically, the active bleeding qualifies her for K26.4 along with the appropriate code for the perforation
Documentation should include details of the patient's symptoms (e.g., abdominal pain, melena, hematemesis), relevant medical history (e.g., prior peptic ulcer disease, use of NSAIDs), diagnostic findings from endoscopy or imaging studies confirming the presence and characteristics of the ulcer and the bleeding, and any interventions performed (e.g., endoscopic hemostasis, surgery).Documentation of the chronicity or unspecified nature of the ulcer is also essential.
** Excludes1: peptic ulcer NOS (K27.-). Use additional code to identify: alcohol abuse and dependence (F10.-)
- Specialties:Gastroenterology, Internal medicine, General surgery
- Place of Service:Inpatient Hospital, Emergency Room - Hospital,Office