K25.1
BillableAcute gastric ulcer with perforation
HCC Category Mapping
V28HCC 78 — Intestinal Obstruction/Perforation
0.000V24HCC 33 — Intestinal Obstruction/Perforation
0.226ESRDHCC 33 — Intestinal Obstruction/Perforation
0.000What This Code Means
A sudden, severe ulcer in the stomach that has created a hole through the stomach wall.
Coding Tips
- •This is a surgical emergency; verify whether surgical repair was performed
- •Document the date of perforation and any peritonitis or sepsis that resulted
Clinical Significance
Acute gastric ulcer with perforation is a surgical emergency where stomach acid and contents leak into the peritoneal cavity, causing peritonitis and potentially fatal sepsis. This condition carries significant morbidity and mortality, requiring emergency surgical intervention. Accurate coding reflects the true acuity and resource utilization of these patients.
Documentation Requirements
- ✓Provider documentation of acute gastric ulcer with perforation confirmed by imaging or surgical findings
- ✓Evidence of perforation (free air on imaging, peritoneal signs on exam, or operative findings)
- ✓Acuity specified as acute (not chronic or unspecified)
- ✓Location confirmed as gastric (stomach), not duodenal or jejunal
- ✓Surgical intervention documentation and any complications (peritonitis, sepsis)
Commonly Confused Codes
K25.0 — Acute gastric ulcer with hemorrhage: bleeding only, no perforationK25.2 — Acute gastric ulcer with both hemorrhage and perforation: use when BOTH complications are presentK25.5 — Chronic or unspecified gastric ulcer with perforation: different acuity — chronic or unspecifiedK26.1 — Acute duodenal ulcer with perforation: different anatomic site (duodenum vs. stomach)K27.1 — Acute peptic ulcer, site unspecified, with perforation: use only when the site cannot be determined
Code Hierarchy
└K25Gastric ulcer└K25.1Acute gastric ulcer with perforation
└K25.1Acute gastric ulcer with perforation