Peptic Ulcer Disease ICD-10-CM codes

Site determines the category: K25 gastric ulcer, K26 duodenal ulcer, K27 peptic ulcer with site unspecified, and K28 gastrojejunal ulcer. All four share the same fourth-character scheme: 0 acute with hemorrhage, 1 acute with perforation, 2 acute with both, 3 acute without hemorrhage or perforation, 4 chronic or unspecified with hemorrhage, 5 chronic or unspecified with perforation, 6 chronic or unspecified with both, 7 chronic without hemorrhage or perforation, and 9 unspecified as acute or chronic without hemorrhage or perforation.

A gastric ulcer documented with no acuity and no complication is K25.9. A bleeding gastric ulcer with no acuity is K25.4, and a perforated duodenal ulcer is K26.5 or K26.1. Because hemorrhage is part of the code, K92.0, K92.1, or K92.2 is not added for the bleeding.

Helicobacter pylori infection is reported with B96.81 as an additional code after the ulcer code. For NSAID-induced ulcers, add the adverse effect code (T39.395A for other NSAIDs) and Z79.1 for long-term NSAID use. K25 also carries a use-additional-code note for alcohol abuse and dependence (F10.-). Peptic ulcer NOS is K27.-, not K25, and acute gastritis is excluded from K25 and coded to K29.0-.