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ICD-10 Guide
ICD-10 CodesK25.0

K25.0

Billable

Acute gastric ulcer with hemorrhage

BILLABLE STATUSYes
IMPLEMENTATION DATEOctober 1, 2015
LAST UPDATED09/06/2025

Code Description

ICD-10 K25.0 is a billable code used to indicate a diagnosis of acute gastric ulcer with hemorrhage.

Key Diagnostic Point:

K25.0 refers to an acute gastric ulcer with hemorrhage, a serious condition characterized by the formation of an ulcer in the gastric mucosa that results in bleeding. The stomach, part of the alimentary tract, is lined with a protective mucosal layer, and when this layer is compromised, it can lead to ulceration. Clinical presentation often includes symptoms such as severe abdominal pain, nausea, vomiting (which may contain blood), and signs of gastrointestinal bleeding such as melena or hematemesis. The disease can progress rapidly, leading to complications like perforation or significant blood loss, necessitating immediate medical intervention. Diagnosis typically involves endoscopy, which allows for direct visualization of the ulcer and assessment of bleeding. Other diagnostic considerations may include imaging studies and laboratory tests to evaluate hemoglobin levels and overall health status. Prompt diagnosis and treatment are crucial to prevent severe complications and improve patient outcomes.

Code Complexity Analysis

Complexity Rating: High

High Complexity

Complexity Factors

  • Diagnostic complexity
  • Treatment complexity
  • Documentation requirements
  • Coding specificity

Audit Risk Factors

  • Common coding errors include misclassifying the type of ulcer or failing to document the presence of hemorrhage.
  • Documentation gaps may arise if the clinical notes do not clearly indicate the severity of the ulcer or the presence of bleeding.
  • Billing challenges can occur if the treatment provided is not adequately supported by documentation, leading to potential denials.

Specialty Focus

Medical Specialties

Gastroenterology

Documentation Requirements

Standard ICD-10-CM documentation requirements apply

Common Clinical Scenarios

Various clinical presentations within this specialty area

Billing Considerations

Follow specialty-specific billing guidelines

Emergency Medicine

Documentation Requirements

Standard ICD-10-CM documentation requirements apply

Common Clinical Scenarios

Various clinical presentations within this specialty area

Billing Considerations

Follow specialty-specific billing guidelines

Related ICD-10 Codes

Related CPT Codes

CPT Code

Clinical Scenario

Documentation Requirements

CPT Code

Clinical Scenario

Documentation Requirements

ICD-10 Impact

Diagnostic & Documentation Impact

Enhanced Specificity

ICD-10 Improvements

The clinical significance of K25.0 lies in its potential for severe complications, including significant blood loss and the need for surgical intervention. The population health impact is notable, as gastric ulcers are prevalent in various demographics, particularly among those with risk factors such as NSAID use, alcohol consumption, and Helicobacter pylori infection. Quality measures related to timely diagnosis and treatment can influence healthcare utilization patterns, as patients with untreated ulcers may require emergency care or hospitalization, thereby increasing healthcare costs and resource utilization.

ICD-9 vs ICD-10

The clinical significance of K25.0 lies in its potential for severe complications, including significant blood loss and the need for surgical intervention. The population health impact is notable, as gastric ulcers are prevalent in various demographics, particularly among those with risk factors such as NSAID use, alcohol consumption, and Helicobacter pylori infection. Quality measures related to timely diagnosis and treatment can influence healthcare utilization patterns, as patients with untreated ulcers may require emergency care or hospitalization, thereby increasing healthcare costs and resource utilization.

Reimbursement & Billing Impact

Reimbursement considerations include the severity of the condition and the complexity of the treatment provided. Common denials may arise from insufficient documentation or failure to demonstrate medical necessity for procedures performed. Coders should ensure that all relevant clinical notes, imaging, and procedural reports are included in the patient's medical record to support the claim. Adhering to coding best practices, such as using the most specific code available and ensuring accurate representation of the clinical scenario, will help mitigate billing challenges.

Resources

Clinical References

  • •
    ICD-10 Official Guidelines for K00-K99
  • •
    Clinical Documentation Requirements

Coding & Billing References

  • •
    ICD-10 Official Guidelines for K00-K99
  • •
    Clinical Documentation Requirements

Frequently Asked Questions

What specific conditions are covered by K25.0?

K25.0 specifically covers acute gastric ulcers that are accompanied by hemorrhage. This includes ulcers that have caused bleeding into the gastrointestinal tract, which may be evidenced by hematemesis or melena.

When should K25.0 be used instead of related codes?

K25.0 should be used when there is clear documentation of an acute gastric ulcer with active bleeding. If the ulcer is present without hemorrhage, K25.1 should be utilized instead.

What documentation supports K25.0?

Documentation must include clinical findings that confirm the presence of an acute gastric ulcer and evidence of hemorrhage, such as endoscopic reports, imaging studies, and laboratory results indicating blood loss.