ICD-10 Coding for Gastric Ulcer Disease(K25.0, K25.1)
Complete ICD-10-CM coding and documentation guide for Gastric Ulcer Disease. Includes clinical validation requirements, documentation requirements, and coding pitfalls.
Also known as:
Related ICD-10 Code Ranges
Complete code families applicable to Gastric Ulcer Disease
K25.0-K25.9Primary Range
Gastric ulcer codes
These codes cover various types of gastric ulcers, including acute and chronic, with or without complications such as hemorrhage or perforation.
Code Comparison: When to Use Each Code
Compare key differences between these codes to ensure accurate selection
| Code | Description | When to Use | Key Documentation |
|---|---|---|---|
| K25.0 | Acute gastric ulcer with hemorrhage | Use when there is documented acute gastric ulcer with active bleeding. |
|
| K25.1 | Acute gastric ulcer with perforation | Use when there is documented acute gastric ulcer with perforation. |
|
Clinical Decision Support
Always review the patient's clinical documentation thoroughly. When in doubt, choose the more specific code and ensure documentation supports it.
Key Information: ICD-10 code for gastric ulcer with hemorrhage
Essential facts and insights about Gastric Ulcer Disease
Primary ICD-10-CM Codes for gastric ulcer disease
Decision Criteria
clinical Criteria
- Presence of active bleeding confirmed by EGD
Applicable To
- Acute gastric ulcer with bleeding
Excludes
- Chronic gastric ulcer with hemorrhage (K25.4)
Clinical Validation Requirements
- Endoscopic evidence of bleeding
- Hemoglobin drop ≥2g/dL
Code-Specific Risks
- Misclassification if chronicity is not specified
Coding Notes
- Ensure documentation specifies 'acute' and 'with hemorrhage'.
K25.1 - Acute gastric ulcer with perforation
Use when there is documented acute gastric ulcer with perforation.
Applicable To
- Acute gastric ulcer with perforation
Excludes
- Chronic gastric ulcer with perforation (K25.5)
Clinical Validation Requirements
- Imaging showing pneumoperitoneum
- Surgical confirmation of perforation
Coding Notes
Ensure documentation specifies 'acute' and 'with perforation'.
Ancillary Codes
Additional codes that should be used in conjunction with the main diagnosis codes when applicable.
Alcohol dependence, uncomplicated
F10.20Documentation & Coding Risks
Avoid these common documentation and coding issues when documenting Gastric Ulcer Disease to ensure proper reimbursement, maintain compliance, and reduce audit risk. These guidelines are particularly important when using ICD-10 code K25.0.
Impact
Clinical: May lead to inappropriate treatment., Regulatory: Non-compliance with coding standards., Financial: Potential for reduced reimbursement.
Mitigation Strategy
Ensure endoscopic findings are documented, Verify hemoglobin levels
Impact
Reimbursement: Incorrect coding can lead to improper DRG assignment., Compliance: May trigger audits due to lack of specificity., Data Quality: Impacts the accuracy of clinical data.
Mitigation Strategy
Query the provider to specify if the ulcer is acute or chronic.
Impact
Lack of specificity in ulcer documentation can lead to audits.
Mitigation Strategy
Ensure detailed documentation of ulcer type and complications.
Documentation errors, coding pitfalls, and audit risks are interconnected aspects of medical coding and billing. Addressing all three areas helps ensure accurate coding, optimal reimbursement, and regulatory compliance.
Frequently Asked Questions
Common questions about ICD-10 coding for Gastric Ulcer Disease, with expert answers to help guide accurate code selection and documentation.
Documentation Templates for Gastric Ulcer Disease
Use these documentation templates to ensure complete and accurate documentation for Gastric Ulcer Disease. These templates include all required elements for proper coding and billing.
Acute gastric ulcer with hemorrhage
Specialty: GastroenterologyRequired Elements
- Patient history
- Endoscopic findings
- Hemoglobin levels
Example Documentation
Examples: Poor vs. Good Documentation
Poor Documentation Example
Good Documentation Example
Explanation
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