ICD-10 Logo
ICDxICD-10 Medical Coding
ICD-10 Logo
ICDxICD-10 Medical Coding
ICD 10 CodesDiagnoses
ICD 10 CodesDiagnoses
ICD-10 Logo
ICDxICD-10 Medical Coding

Comprehensive ICD-10-CM code reference with AI-powered search capabilities.

© 2025 ICD Code Compass. All rights reserved.

Browse

  • All Chapters
  • All Categories
  • Diagnoses

Tools

  • AI Code Search
ICD-10-CM codes are maintained by the CDC and CMS. This tool is for reference purposes only.
v1.0.0
ICD-10 Guide
ICD-10 CodesK26.7

K26.7

Billable

Chronic duodenal ulcer without hemorrhage or perforation

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

Code Description

ICD-10 K26.7 is a billable code used to indicate a diagnosis of chronic duodenal ulcer without hemorrhage or perforation.

Key Diagnostic Point:

Chronic duodenal ulcer without hemorrhage or perforation is a condition characterized by a long-standing ulceration of the duodenum, the first part of the small intestine. Clinically, patients may present with epigastric pain, which often occurs after meals, and may be relieved by antacids or food. The anatomy involved includes the duodenum, which is situated just after the stomach and plays a crucial role in digestion by receiving chyme from the stomach and bile from the liver. Disease progression can lead to complications if not managed properly, although in this specific code, there are no indications of hemorrhage or perforation. Diagnostic considerations include a thorough patient history, physical examination, and possibly endoscopic evaluation to confirm the presence of an ulcer. Laboratory tests may also be conducted to rule out H. pylori infection, which is a common cause of duodenal ulcers. Proper diagnosis is essential for effective management and treatment planning.

Code Complexity Analysis

Complexity Rating: Medium

Medium Complexity

Complexity Factors

  • Diagnostic complexity: Requires differentiation from other gastrointestinal disorders.
  • Treatment complexity: May involve medication management and lifestyle modifications.
  • Documentation requirements: Necessitates clear documentation of symptoms and diagnostic findings.
  • Coding specificity: Requires precise coding to avoid misclassification.

Audit Risk Factors

  • Common coding errors: Misclassification with other ulcer codes.
  • Documentation gaps: Incomplete patient history or lack of diagnostic evidence.
  • Billing challenges: Potential denials if documentation does not support the diagnosis.

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

Primary Care

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

CPT Code

Clinical Scenario

Documentation Requirements

ICD-10 Impact

Diagnostic & Documentation Impact

Enhanced Specificity

ICD-10 Improvements

Chronic duodenal ulcers can significantly impact patient quality of life and healthcare utilization, leading to increased visits to healthcare providers and potential hospitalizations if complications arise. Understanding the epidemiology of this condition is crucial, as it affects a notable portion of the population, particularly those with risk factors such as H. pylori infection, NSAID use, and smoking. Quality measures may focus on effective management and prevention of complications associated with chronic ulcers.

ICD-9 vs ICD-10

Chronic duodenal ulcers can significantly impact patient quality of life and healthcare utilization, leading to increased visits to healthcare providers and potential hospitalizations if complications arise. Understanding the epidemiology of this condition is crucial, as it affects a notable portion of the population, particularly those with risk factors such as H. pylori infection, NSAID use, and smoking. Quality measures may focus on effective management and prevention of complications associated with chronic ulcers.

Reimbursement & Billing Impact

Reimbursement considerations include ensuring that the diagnosis is clearly linked to the services provided. Common denials may arise from insufficient documentation or failure to demonstrate medical necessity. Best practices include maintaining thorough records of patient visits, treatment plans, and any diagnostic tests performed to substantiate the diagnosis and treatment of the ulcer.

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 K26.7?

K26.7 specifically covers chronic duodenal ulcers that are not associated with hemorrhage or perforation. It is important to differentiate this from acute ulcers or those with complications.

When should K26.7 be used instead of related codes?

K26.7 should be used when a patient has a documented chronic duodenal ulcer without any signs of bleeding or perforation, ensuring that the clinical picture aligns with the code's definition.

What documentation supports K26.7?

Documentation should include a clear diagnosis of a chronic duodenal ulcer, patient symptoms, results from any imaging or endoscopic procedures, and treatment plans that reflect the chronic nature of the condition.