2025 ICD-10-CM code K26.2
(Active) Effective Date: N/A Revision Date: N/A Deletion Date: N/A Diseases of esophagus, stomach and duodenum - Duodenal ulcer Diseases of the digestive system Feed
Acute duodenal ulcer with both hemorrhage and perforation.
Modifiers may be applicable depending on the specific circumstances of the procedure(s) performed.For example, modifiers may be used to indicate multiple procedures or to specify the location of the service.Consult the official CPT and modifier guidelines for appropriate usage.
Medical necessity for treatment of K26.2 is established by the presence of active bleeding requiring intervention to prevent hemodynamic instability, and/or the presence of perforation requiring surgical or endoscopic repair to prevent peritonitis (infection of the abdominal cavity) and other life-threatening complications.The severity of the symptoms and the risk of complications determine the urgency of treatment.
The clinical responsibility for managing a patient with K26.2 involves a gastroenterologist or surgeon.Initial management often focuses on stabilizing the patient's condition (stopping the bleeding, managing the perforation). This could involve endoscopy (to visualize and potentially treat the bleeding), intravenous fluids, blood transfusions, and potentially surgery to repair the perforation. Post-operative care includes monitoring for complications, pain management, and dietary adjustments.
In simple words: This code means you have a serious open sore in the first part of your small intestine (duodenum).This sore is causing bleeding and has also broken through the intestinal wall.
This code signifies an acute duodenal ulcer (a peptic ulcer in the duodenum, the first part of the small intestine) that is complicated by both hemorrhage (bleeding) and perforation (a hole in the ulcer).
Example 1: A 60-year-old male presents to the emergency room with severe epigastric pain, hematemesis (vomiting blood), and hemodynamic instability (low blood pressure). Endoscopy reveals an actively bleeding duodenal ulcer with perforation. He undergoes emergency surgery to repair the perforation and control the bleeding., A 45-year-old female is admitted with melena (dark, tarry stools), epigastric discomfort, and a history of NSAID use.Endoscopy reveals a perforated duodenal ulcer with ongoing slow bleeding. She is stabilized with intravenous fluids and transfusions and undergoes endoscopic hemostasis (closure of the bleeding vessel). Due to lack of ongoing bleeding, surgery is not required., A 72-year-old male with a history of peptic ulcer disease and alcohol abuse is found unresponsive at home. He is taken to the hospital and found to have signs of shock (low blood pressure, fast heart rate) and abdominal distension.Emergency laparotomy (abdominal surgery) reveals a perforated duodenal ulcer with significant hemorrhage. The patient undergoes surgical repair and intensive care.
Complete medical history, physical examination notes, endoscopic findings (if performed), operative reports (if surgery performed), laboratory results (complete blood count, blood type and cross-match, coagulation studies, electrolyte levels), imaging studies (abdominal x-rays, CT scans), and pathology reports (if tissue samples obtained).
** This code is used for acute conditions; chronic ulcers with similar complications would be coded differently.Always ensure complete and accurate documentation to support code selection.Consider using additional codes to specify contributing factors, such as alcohol abuse or NSAID use.
- Payment Status: Active
- Specialties:Gastroenterology, Surgery
- Place of Service:Emergency Room - Hospital, Inpatient Hospital, Ambulatory Surgical Center