2025 ICD-10-CM code K27.4
(Active) Effective Date: N/A Revision Date: N/A Diseases of the digestive system - Diseases of esophagus, stomach and duodenum (K20-K31) Diseases of the digestive system (K00-K95) Feed
Chronic or unspecified peptic ulcer, site unspecified, with hemorrhage.
Medical necessity for services related to K27.4 relies on demonstrating the presence of active bleeding from a chronic or unspecified peptic ulcer. The documentation should clearly link the patient's symptoms, diagnostic findings, and treatment to the presence of a bleeding ulcer.For example, blood transfusions, endoscopic interventions to stop bleeding, or medications to manage the ulcer and its complications would be justified by the diagnosis.
Clinicians responsible for diagnosing and managing K27.4 include gastroenterologists, general surgeons, internists, and family medicine practitioners. Their responsibilities encompass obtaining a thorough history, physical examination, ordering appropriate diagnostic tests (such as esophagogastroduodenoscopy, upper GI series, laboratory tests for H. pylori infection and anemia), and formulating a treatment plan.This plan may involve medications (e.g., proton pump inhibitors, H2 blockers, antibiotics), lifestyle modifications (e.g., dietary changes, smoking cessation, avoidance of NSAIDs), and in some cases, surgical intervention.
In simple words: This code indicates a bleeding ulcer in your stomach or intestines. It's either been there for a while (chronic) or the doctor isn't sure how long it's been there. The exact spot of the ulcer isn't specified in the medical records.
This code signifies a peptic ulcer, a deep wound, of unspecified location within the gastrointestinal tract that is chronic or of unspecified duration, and is currently presenting with active bleeding (hemorrhage).The ulcer may be located in the stomach or duodenum, but the specific site is not documented. The condition is chronic, implying it has persisted for a significant period or the duration of the ulcer is unknown.
Example 1: A 55-year-old patient with a history of NSAID use presents with chronic epigastric pain and recent onset of bloody stools. Endoscopy reveals a bleeding ulcer in the stomach, the precise location of which is not specified in the operative report.The ulcer is determined to be chronic based on its appearance.K27.4 is used for coding., A patient with a long history of intermittent upper abdominal pain and discomfort presents to the emergency room with hematemesis (vomiting blood).While the specific site and chronicity of the ulcer aren't immediately determinable due to the acute nature of the presentation, the clinical picture suggests a peptic ulcer with hemorrhage. The physician uses K27.4 as a preliminary diagnosis pending further investigation., A 70-year-old patient with a past medical history of peptic ulcer disease is admitted for anemia and melena (black, tarry stools).The previous ulcer location is not documented in the current record.Upper endoscopy confirms active bleeding from an ulcer, but the report doesn't definitively specify its location or chronicity.K27.4 is appropriate given the clinical context.
Documentation should include details about the patient's symptoms (e.g., abdominal pain, nausea, vomiting, bloody or dark stools, signs of anemia), history of peptic ulcer disease or related factors (e.g., NSAID use, H. pylori infection), diagnostic findings (e.g., endoscopic or radiographic evidence of an ulcer, laboratory results), and treatment provided.The documentation should also mention whether the ulcer is acute or chronic if known, even if the site is unspecified.
** Hiatus hernia is excluded from this subcategory.
- Payment Status: Active
- Specialties:Gastroenterology, General Surgery, Internal Medicine, Family Medicine
- Place of Service:Inpatient Hospital, Emergency Room - Hospital,Office, Outpatient Hospital