K26.5
BillableChronic or unspecified 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 chronic or long-standing ulcer in the duodenum that has broken through the duodenal wall, allowing digestive contents to leak into the abdominal cavity.
Coding Tips
- •Perforation in chronic ulcers may present differently than acute perforation; ensure documentation reflects the chronic nature
- •Distinguish from K26.1 (acute perforation) by confirming the chronic status of the ulcer
Clinical Significance
Chronic or unspecified duodenal ulcer with perforation reflects a longstanding ulcer that has progressively eroded through the duodenal wall. Chronic perforations may present as contained or sealed off, but still carry risk of peritonitis and sepsis. This code captures patients with persistent or recurrent ulcer disease who develop this serious complication.
Documentation Requirements
- ✓Provider documentation of duodenal ulcer with perforation specified as chronic or left unspecified
- ✓Evidence of perforation on imaging or operative findings
- ✓History consistent with chronic or recurrent ulcer disease
- ✓Location confirmed as duodenal
- ✓Helicobacter pylori status and NSAID use history
- ✓Treatment plan including surgical intervention if indicated
Commonly Confused Codes
K26.1 — Acute duodenal ulcer with perforation: use when documentation clearly states acute onsetK26.6 — Chronic or unspecified duodenal ulcer with both hemorrhage and perforation: use when bleeding is also presentK26.7 — Chronic duodenal ulcer without hemorrhage or perforation: no perforation presentK25.5 — Chronic or unspecified gastric ulcer with perforation: gastric, not duodenal locationK27.5 — Chronic or unspecified peptic ulcer, site unspecified, with perforation: site not determined
Code Hierarchy
└K26Duodenal ulcer└K26.5Chronic or unspecified duodenal ulcer with perforation
└K26.5Chronic or unspecified duodenal ulcer with perforation