K26.6

HCC Category Mapping

What This Code Means

A chronic or long-standing ulcer in the duodenum (first part of small intestine) that is actively bleeding and has a hole through the wall.

Coding Tips

• •This code indicates both hemorrhage and perforation are present; do not use additional codes for these complications
• •Verify clinical documentation specifies 'chronic' or 'unspecified' status; if acute, use a different K26 code

Clinical Significance

Chronic or unspecified duodenal ulcer with both hemorrhage and perforation represents the most severe chronic duodenal ulcer presentation, with concurrent active bleeding and wall penetration. This dual complication often indicates treatment failure or refractory disease requiring aggressive surgical management. Accurate capture of both complications is essential for reflecting true disease severity.

Documentation Requirements

• ✓Provider documentation confirming BOTH hemorrhage AND perforation in a chronic or unspecified duodenal ulcer
• ✓Evidence of hemorrhage (GI bleeding, hemoglobin drop, endoscopic findings)
• ✓Evidence of perforation (free air, peritoneal irritation, operative confirmation)
• ✓Chronicity documented or acuity left unspecified
• ✓Location confirmed as duodenal
• ✓Comprehensive intervention documentation for both complications

Commonly Confused Codes