K26.2
BillableAcute duodenal 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 newly developed duodenal ulcer that is both actively bleeding and has perforated through the duodenal wall, representing a critical dual complication.
Coding Tips
- •This code requires documentation of BOTH hemorrhage AND perforation; verify both complications are present before coding
- •This is a life-threatening condition requiring immediate surgical intervention; ensure severity is reflected in documentation
Clinical Significance
Acute duodenal ulcer with both hemorrhage and perforation is a life-threatening dual complication representing the most severe acute duodenal ulcer presentation. The simultaneous bleeding and perforation creates a complex surgical emergency requiring both hemorrhage control and closure of the duodenal defect. This condition carries the highest morbidity among duodenal ulcer complications.
Documentation Requirements
- ✓Provider documentation confirming BOTH hemorrhage AND perforation simultaneously
- ✓Evidence of active hemorrhage (hematemesis, melena, hemodynamic instability, transfusion needs)
- ✓Evidence of perforation (free air on imaging, peritoneal signs, operative findings)
- ✓Acuity confirmed as acute
- ✓Location confirmed as duodenal
- ✓Documentation of both hemostatic and surgical interventions
Commonly Confused Codes
K26.0 — Acute duodenal ulcer with hemorrhage: hemorrhage only, no perforationK26.1 — Acute duodenal ulcer with perforation: perforation only, no hemorrhageK26.6 — Chronic or unspecified duodenal ulcer with both hemorrhage and perforation: chronic or unspecified acuityK25.2 — Acute gastric ulcer with both hemorrhage and perforation: gastric, not duodenal location