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K25.9
ICD-10-CM
Gastric Ulcer Disease

Find comprehensive information on Gastric Ulcer Disease diagnosis, including clinical documentation requirements, ICD-10 codes K25 and related codes, medical coding guidelines, and healthcare best practices for accurate diagnosis and treatment. Learn about peptic ulcer disease, gastritis, H pylori infection testing, endoscopic findings, and symptom management for optimal patient care. This resource provides essential details for physicians, nurses, coders, and other healthcare professionals involved in the diagnosis and management of gastric ulcers.

Also known as

Stomach Ulcer
Peptic Ulcer

Diagnosis Snapshot

Key Facts
  • Definition : Open sore in the stomach lining, often caused by H. pylori infection or NSAID use.
  • Clinical Signs : Burning stomach pain, nausea, vomiting, bloating, indigestion, weight loss, dark stools.
  • Common Settings : Primary care, gastroenterology clinics, hospitals (for complications like bleeding).

Related ICD-10 Code Ranges

Complete code families applicable to AAPC K25.9 Coding
K25-K28

Gastric and duodenal ulcer

Covers all types of ulcers affecting the stomach and duodenum.

K25.0-K25.7

Gastric ulcer

Specifies ulcers located in the stomach, excluding the pylorus.

K26-K26.9

Duodenal ulcer

Specifies ulcers occurring in the duodenum.

K27-K27.9

Peptic ulcer NOS

Used for peptic ulcers not otherwise specified as gastric or duodenal.

Code-Specific Guidance

Decision Tree for

Follow this step-by-step guide to choose the correct ICD-10 code.

Active bleeding from gastric ulcer?

  • Yes

    Site of active bleed specified?

  • No

    Ulcer is perforated?

Code Comparison

Related Codes Comparison

When to use each related code

Description
Gastric ulcer
Duodenal ulcer
Gastroesophageal reflux disease (GERD)

Documentation Best Practices

Documentation Checklist
  • H. pylori test result documented
  • Ulcer location and size specified
  • Symptoms: e.g., epigastric pain
  • Endoscopy findings described
  • Medications and treatment plan

Mitigation Tips

Best Practices
  • Code Z12.0 for routine endoscopy GUD screening.
  • Document H.pylori test, ulcer location, size for CDI.
  • Ensure proper ICD-10-CM coding for compliance: K25-K28
  • For hemorrhage, add code K92.2 to primary diagnosis.
  • Use SNOMED CT for detailed GUD documentation compliance.

Clinical Decision Support

Checklist
  • Verify H. pylori test (ICD-10: B96.81) documented.
  • Confirm ulcer location & size in endoscopic report (SNOMED CT: 224684004).
  • Check NSAID use (RxNorm: 865027) and document interaction risk.
  • Review biopsy results for malignancy (ICD-10: C16) if obtained.

Reimbursement and Quality Metrics

Impact Summary
  • Gastric Ulcer Disease reimbursement hinges on accurate ICD-10-CM K25 coding, impacting MS-DRG assignment and payment.
  • Coding quality directly affects hospital Case Mix Index (CMI) for Gastric Ulcer Disease, influencing overall revenue.
  • Accurate POA indicator reporting for Gastric Ulcer Disease impacts hospital quality metrics and potential penalties.
  • Appropriate Present on Admission (POA) coding for K25 impacts hospital Value Based Purchasing (VBP) performance.

Streamline Your Medical Coding

Let S10.AI help you select the most accurate ICD-10 codes for . Our AI-powered assistant ensures compliance and reduces coding errors.

Frequently Asked Questions

Common Questions and Answers

Q: What are the most effective triple therapy regimens for H. pylori-associated gastric ulcer disease in penicillin-allergic patients?

A: For penicillin-allergic patients with H. pylori-associated gastric ulcer disease, effective triple therapy regimens typically involve a proton pump inhibitor (PPI) like omeprazole or lansoprazole, metronidazole, and clarithromycin. Alternatively, bismuth quadruple therapy, consisting of a PPI, bismuth subsalicylate, metronidazole, and tetracycline, is another viable option. The choice between these regimens depends on local resistance patterns and patient-specific factors like comorbidities and medication interactions. Consider implementing antibiotic susceptibility testing when possible to tailor treatment and improve eradication rates. Explore how regional resistance patterns influence treatment selection for H. pylori.

Q: How can I differentiate between gastric ulcer and gastric cancer during endoscopic evaluation, and what are the key diagnostic features to look for?

A: Differentiating between gastric ulcer and gastric cancer during endoscopy requires careful assessment of several key features. Benign ulcers typically present with regular, smooth margins, a clean base, and radiating folds converging towards the ulcer crater. In contrast, malignant ulcers often exhibit irregular, raised, or nodular margins, a necrotic or friable base, and disrupted or clubbed surrounding folds. Furthermore, the location, size, and appearance of the ulcer can provide valuable clues. While endoscopic appearance can be suggestive, histopathological examination of biopsies obtained during endoscopy remains the gold standard for definitive diagnosis. Learn more about advanced endoscopic imaging techniques like narrow-band imaging or confocal laser endomicroscopy that can aid in differentiating between benign and malignant lesions.

Quick Tips

Practical Coding Tips
  • Code K25.x for gastric ulcer
  • Specify location, acuteness
  • Document H.pylori status
  • Code complications like perforation
  • Consider endoscopic findings

Documentation Templates

Patient presents with complaints consistent with gastric ulcer disease, including epigastric pain, burning sensation in the stomach, nausea, and indigestion.  Symptoms are described as gnawing or aching and often occur between meals or during the night.  Patient reports symptom relief with antacids.  On physical examination, tenderness to palpation in the epigastric region was noted.  Differential diagnosis includes peptic ulcer disease, gastritis, gastroesophageal reflux disease (GERD), and functional dyspepsia.  Diagnostic workup may include esophagogastroduodenoscopy (EGD) with biopsy to visualize the ulcer and rule out Helicobacter pylori infection, urea breath test, or stool antigen test.  Assessment includes evaluating for risk factors such as NSAID use, smoking history, and family history of ulcers.  Plan includes initiating proton pump inhibitor (PPI) therapy for acid suppression, H. pylori eradication therapy if indicated, lifestyle modifications such as smoking cessation and dietary adjustments, and follow-up EGD to assess ulcer healing.  Patient education provided on medication management, potential complications such as bleeding and perforation, and importance of adherence to the treatment plan.  ICD-10 code K25.x will be used for billing purposes, with specific code selection dependent upon ulcer location and characteristics documented. CPT codes for procedures performed, such as EGD (43239) or biopsy (43239), will also be included for appropriate medical billing and coding.  Follow-up scheduled in four to eight weeks to assess response to treatment and monitor for any complications.