K26.1
BillableAcute duodenal 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 newly developed ulcer in the duodenum that has broken through the duodenal wall, creating a hole that allows digestive contents to leak into the abdominal cavity.
Coding Tips
- •Perforation is a surgical emergency; ensure documentation clearly indicates perforation and acute status
- •Distinguish from K26.2 which includes both hemorrhage and perforation
Clinical Significance
Acute duodenal ulcer with perforation is a surgical emergency where the duodenal wall is breached, allowing intestinal contents to spill into the peritoneal cavity. Duodenal perforations are more common than gastric perforations and are strongly associated with Helicobacter pylori infection and NSAID use. This condition requires immediate surgical intervention and reflects high-acuity care needs.
Documentation Requirements
- ✓Provider documentation of acute duodenal ulcer with confirmed perforation
- ✓Evidence of perforation (free air under diaphragm on X-ray, CT findings, or operative report)
- ✓Acuity specified as acute
- ✓Location confirmed as duodenal (first part of small intestine), not gastric
- ✓Surgical findings and intervention details
- ✓Helicobacter pylori and NSAID use assessment
Commonly Confused Codes
K26.0 — Acute duodenal ulcer with hemorrhage: bleeding only, no perforationK26.2 — Acute duodenal ulcer with both hemorrhage and perforation: use when both complications existK26.5 — Chronic or unspecified duodenal ulcer with perforation: different acuityK25.1 — Acute gastric ulcer with perforation: different anatomic location (stomach vs. duodenum)K27.1 — Acute peptic ulcer, site unspecified, with perforation: use only when the site truly cannot be determined
Code Hierarchy
└K26Duodenal ulcer└K26.1Acute duodenal ulcer with perforation
└K26.1Acute duodenal ulcer with perforation