K25.2
BillableAcute gastric ulcer with both hemorrhage and 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 is both bleeding and has perforated through the stomach wall.
Coding Tips
- •This represents the most severe acute gastric ulcer presentation requiring urgent intervention
- •Document both the hemorrhage management and surgical repair of perforation
Clinical Significance
Acute gastric ulcer with both hemorrhage and perforation represents the most severe acute ulcer presentation, with simultaneous active bleeding and full-thickness wall penetration. This dual complication carries the highest mortality risk among gastric ulcer presentations and requires emergent multi-modal intervention. Accurate capture is critical for reflecting true case severity.
Documentation Requirements
- ✓Provider documentation confirming BOTH hemorrhage AND perforation are present simultaneously
- ✓Evidence of hemorrhage (hematemesis, melena, hemoglobin drop, endoscopic findings)
- ✓Evidence of perforation (free air on imaging, peritoneal signs, operative findings)
- ✓Acuity documented as acute
- ✓Location confirmed as gastric (stomach)
- ✓Documentation of surgical and hemostatic interventions performed
Commonly Confused Codes
K25.0 — Acute gastric ulcer with hemorrhage: use when only bleeding is present, no perforationK25.1 — Acute gastric ulcer with perforation: use when only perforation is present, no hemorrhageK25.6 — Chronic or unspecified gastric ulcer with both hemorrhage and perforation: different acuityK26.2 — Acute duodenal ulcer with both hemorrhage and perforation: different anatomic location
Code Hierarchy
└K25Gastric ulcer└K25.2Acute gastric ulcer with both hemorrhage and perforation
└K25.2Acute gastric ulcer with both hemorrhage and perforation