2025 ICD-10-CM code K26.5
(Active) Effective Date: N/A Revision Date: N/A Deletion Date: N/A Diseases of the digestive system - Duodenal ulcer Diseases of the digestive system Feed
Chronic or unspecified duodenal ulcer with perforation.
Medical necessity for treatment of a perforated duodenal ulcer is established by the presence of perforation confirmed by imaging and clinical findings (severe abdominal pain, signs of peritonitis, shock).The immediate risk of peritonitis (infection of the abdominal cavity), sepsis, and death necessitates urgent surgical intervention.
Gastroenterologists, surgeons, and general practitioners may be involved in the diagnosis and treatment of this condition depending on the severity and the need for surgical intervention.The clinical responsibility includes diagnosing the perforation (often through imaging studies like X-rays or CT scans), stabilizing the patient, and addressing the underlying ulcer disease. Surgical repair of the perforation may be necessary.
In simple words: This code describes a serious complication of a long-standing or unknown type of duodenal ulcer (a sore in the first part of the small intestine).The ulcer has developed a hole in it, allowing stomach contents to leak into the abdomen. This is a medical emergency requiring prompt treatment.
This ICD-10-CM code classifies a chronic or unspecified duodenal ulcer that has perforated.A duodenal ulcer is a circumscribed, inflammatory, and necrotic erosive lesion on the mucosal surface of the duodenal wall.The perforation indicates a hole or rupture in the ulcer, allowing the contents of the duodenum to leak into the abdominal cavity.This condition requires immediate medical attention.
Example 1: A 60-year-old male patient presents to the emergency room with severe abdominal pain, vomiting, and signs of shock.Imaging studies reveal a perforated duodenal ulcer.Emergency surgery is performed to repair the perforation and address the underlying ulcer., A 45-year-old female patient with a history of peptic ulcer disease experiences sudden, intense abdominal pain.Physical examination and diagnostic imaging confirm a perforated chronic duodenal ulcer. The patient undergoes emergency laparotomy for repair of perforation and possible additional interventions such as vagotomy or pyloroplasty if deemed necessary., A 72-year-old patient with a known history of duodenal ulcer disease on long-term NSAID therapy presents with subtle abdominal discomfort.A perforated duodenal ulcer is suspected due to elevated white blood cell count and subtle signs of peritoneal irritation on examination.Urgent surgical intervention is performed to repair the perforation and address the contributing factors such as NSAID use and possible Helicobacter pylori infection.
Detailed history of symptoms, including the onset, location, character, and severity of pain.Complete physical examination noting signs of peritoneal irritation (guarding, rigidity, rebound tenderness).Results of imaging studies (X-rays, CT scans) to confirm perforation and assess the extent of peritonitis.Laboratory test results (complete blood count, electrolytes, blood cultures).Surgical reports including details of the operative findings, procedure performed, and postoperative course.Pathology reports if any tissue samples were obtained.
** Always consider the clinical picture and all available documentation when assigning this code. This is a life-threatening condition requiring immediate medical intervention.Accurate documentation is essential for appropriate billing and reimbursement.
- Payment Status: Active
- Specialties:Surgery, Gastroenterology, Internal Medicine
- Place of Service:Emergency Room - Hospital, Inpatient Hospital, Ambulatory Surgical Center