K25.5
BillableChronic or unspecified 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 chronic or long-standing ulcer in the stomach that has broken through the stomach wall, causing a hole that allows stomach contents to leak into the abdominal cavity.
Coding Tips
- •Perforation is a serious complication requiring immediate medical attention; ensure documentation clearly indicates perforation status
- •Distinguish between acute and chronic ulcers - chronic ulcers have longer duration and different treatment approaches
Clinical Significance
Chronic or unspecified gastric ulcer with perforation indicates a long-standing or poorly characterized ulcer that has eroded through the full thickness of the stomach wall. Chronic ulcers with perforation may present with a different clinical course than acute perforations, sometimes with sealed or contained perforations. This diagnosis reflects ongoing gastrointestinal disease burden and need for definitive management.
Documentation Requirements
- ✓Provider documentation of gastric ulcer with perforation specified as chronic or left unspecified
- ✓Evidence of perforation (imaging, operative findings, or clinical signs of peritonitis)
- ✓History consistent with chronic ulcer disease (duration, prior treatment, recurrence)
- ✓Location confirmed as gastric (stomach)
- ✓Treatment plan including surgical intervention and Helicobacter pylori testing if applicable
Commonly Confused Codes
K25.1 — Acute gastric ulcer with perforation: use when documentation clearly states acute onsetK25.6 — Chronic or unspecified gastric ulcer with both hemorrhage and perforation: use when bleeding is also documentedK25.7 — Chronic gastric ulcer without hemorrhage or perforation: no perforation presentK26.5 — Chronic or unspecified duodenal ulcer with perforation: different anatomic siteK27.5 — Chronic or unspecified peptic ulcer, site unspecified, with perforation: use when site is unknown
Code Hierarchy
└K25Gastric ulcer└K25.5Chronic or unspecified gastric ulcer with perforation
└K25.5Chronic or unspecified gastric ulcer with perforation