Gastric ulcer
In Diseases of esophagus, stomach and duodenum (K20-K31), chapter 11: Diseases of the Digestive System
9 billable codes under K25: 6 are an MCC, 1 is a CC; 4 map to HCC 78 (Intestinal Obstruction/Perforation).A CC or MCC (major CC) is a secondary diagnosis that raises the MS-DRG payment. An HCC counts toward a Medicare Advantage patient's risk score.
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Instructional notes
Includes: conditions that are coded here
- erosion (acute) of stomach
- pylorus ulcer (peptic)
- stomach ulcer (peptic)
Use additional code: add a second code for this, listed after this one
- code to identify:
- alcohol abuse and dependence (F10.-)
Also applies, from Diseases of esophagus, stomach and duodenum (K20-K31)
These notes sit on K20-K31 and apply to every code under it, including K25.
Excludes2: not included here, code separately if applicable
- hiatus hernia (K44.-)
Official coding guidelines
From the ICD-10-CM Official Guidelines for Coding and Reporting, FY 2027 (CMS and NCHS). Links open the PDF at the right page.
There are no chapter-specific rules for Chapter 11 yet, so the general rules in Section I.B apply.
All codes under K25
K25 can't be used on a claim. Pick a billable code below; grey headings group them.
- K25.0Acute gastric ulcer with hemorrhage
- K25.1Acute gastric ulcer with perforation
- K25.2Acute gastric ulcer with both hemorrhage and perforation
- K25.3Acute gastric ulcer without hemorrhage or perforation
- K25.4Chronic or unspecified gastric ulcer with hemorrhage
- K25.5Chronic or unspecified gastric ulcer with perforation
- K25.6Chronic or unspecified gastric ulcer with both hemorrhage and perforation
- K25.7Chronic gastric ulcer without hemorrhage or perforation
- K25.9Gastric ulcer, unspecified as acute or chronic, without hemorrhage or perforation
K25 MS-DRGs
As the principal diagnosis, the billable codes under K25 group to these 8 MS-DRGs (v44.0). Which one applies depends on procedures performed, secondary diagnoses (CC/MCC), and the patient's age and discharge status.
- DRG 380 Complicated Peptic Ulcer with MCC (5 of 9 codes)
- DRG 381 Complicated Peptic Ulcer with CC (5 of 9 codes)
- DRG 382 Complicated Peptic Ulcer without CC/MCC (5 of 9 codes)
- DRG 377 Gastrointestinal Hemorrhage with MCC (4 of 9 codes)
- DRG 378 Gastrointestinal Hemorrhage with CC (4 of 9 codes)
- DRG 379 Gastrointestinal Hemorrhage without CC/MCC (4 of 9 codes)
- DRG 383 Uncomplicated Peptic Ulcer with MCC (3 of 9 codes)
- DRG 384 Uncomplicated Peptic Ulcer without MCC (3 of 9 codes)
Other codes that refer to K25
Notes on these codes point to K25.
About the condition
Plain-language background from MedlinePlus (National Library of Medicine), not coding guidance.
Peptic Ulcer
A peptic ulcer is a sore in the lining of your stomach or your duodenum, the first part of your small intestine. A burning stomach pain is the most common symptom. The pain:
Read more about peptic ulcer on MedlinePlusCode history
Valid since FY2016, when ICD-10-CM took effect on October 1, 2015. No changes since.