2025 ICD-10-CM code K26.6
Chronic or unspecified duodenal ulcer with both hemorrhage and perforation.
Medical necessity for K26.6 relates to the life-threatening complications of hemorrhage and perforation, requiring urgent intervention to stabilize the patient and prevent further complications like sepsis or peritonitis.
Clinicians responsible for diagnosing and managing K26.6 include gastroenterologists, general surgeons, and primary care physicians. They are responsible for ordering appropriate diagnostic tests (such as endoscopy, blood tests, imaging studies), stabilizing the patient (managing bleeding and potential sepsis), providing appropriate treatment (medications, surgery), and follow-up care.
In simple words: This code indicates a long-standing or undefined ulcer in the duodenum, the first part of your small intestine. The ulcer is actively bleeding and has also developed a hole.
This code signifies a chronic (long-standing) or unspecified duodenal ulcer that presents with both bleeding (hemorrhage) and a hole in the duodenal wall (perforation).
Example 1: A 55-year-old patient with a history of peptic ulcer disease presents with severe abdominal pain, coffee-ground emesis (vomiting blood), and signs of shock. Endoscopy confirms a chronic duodenal ulcer with active bleeding and perforation., A 70-year-old patient on long-term NSAID therapy develops sudden-onset abdominal pain and rigidity. Imaging reveals free air under the diaphragm, suggesting a perforated duodenal ulcer. Subsequent endoscopy confirms the presence of a chronic duodenal ulcer with perforation and evidence of recent bleeding., A patient with a history of duodenal ulcers presents with melena (dark, tarry stools) and anemia. Endoscopy reveals a chronic duodenal ulcer with evidence of both bleeding and a small perforation.
Documentation for K26.6 should include: Evidence of a chronic or unspecified duodenal ulcer (e.g., past endoscopic findings, imaging studies); Details of the hemorrhage, such as amount and character of blood loss (e.g., hematemesis, melena); Confirmation of perforation (e.g., free air under the diaphragm on imaging, endoscopic visualization);Associated symptoms, such as abdominal pain, nausea, vomiting; Relevant medical history, including risk factors for duodenal ulcers (e.g., NSAID use, H. pylori infection); Treatment provided, including medications and surgical interventions.
- Payment Status: Active
- Specialties:Gastroenterology, General Surgery, Primary Care Medicine
- Place of Service:Inpatient Hospital, Emergency Room - Hospital