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ICD-10 Guide
ICD-10 CodesK27.9

K27.9

Billable

Peptic ulcer, site unspecified, unspecified as acute or chronic, without hemorrhage or perforation

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

Code Description

ICD-10 K27.9 is a billable code used to indicate a diagnosis of peptic ulcer, site unspecified, unspecified as acute or chronic, without hemorrhage or perforation.

Key Diagnostic Point:

K27.9 refers to a peptic ulcer located at an unspecified site within the gastrointestinal tract, classified as either acute or chronic, without any evidence of hemorrhage or perforation. Peptic ulcers are open sores that develop on the lining of the stomach, small intestine, or esophagus, primarily due to the erosion caused by stomach acid. The clinical presentation may include symptoms such as abdominal pain, bloating, indigestion, and nausea. The anatomy involved typically includes the gastric mucosa and the duodenum. Disease progression can lead to complications if left untreated, including potential bleeding or perforation, which are not applicable in this code. Diagnostic considerations for K27.9 involve a thorough patient history, physical examination, and may include endoscopy or imaging studies to rule out other gastrointestinal conditions. It is crucial to differentiate this code from other peptic ulcer codes that specify the site or complications, ensuring accurate diagnosis and treatment planning.

Code Complexity Analysis

Complexity Rating: Medium

Medium Complexity

Complexity Factors

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

Audit Risk Factors

  • Common coding errors
  • Documentation gaps
  • Billing challenges

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

ICD-10 Impact

Diagnostic & Documentation Impact

Enhanced Specificity

ICD-10 Improvements

The clinical significance of K27.9 lies in its potential to affect patient management and treatment outcomes. Peptic ulcers are prevalent in the population, with lifestyle factors and medication use contributing to their incidence. Understanding the epidemiology of peptic ulcers can help healthcare providers implement preventive measures and improve quality of care. Monitoring treatment outcomes and healthcare utilization patterns related to peptic ulcers can inform public health strategies aimed at reducing complications and enhancing patient education.

ICD-9 vs ICD-10

The clinical significance of K27.9 lies in its potential to affect patient management and treatment outcomes. Peptic ulcers are prevalent in the population, with lifestyle factors and medication use contributing to their incidence. Understanding the epidemiology of peptic ulcers can help healthcare providers implement preventive measures and improve quality of care. Monitoring treatment outcomes and healthcare utilization patterns related to peptic ulcers can inform public health strategies aimed at reducing complications and enhancing patient education.

Reimbursement & Billing Impact

Reimbursement considerations include the need for accurate coding to reflect the severity and complexity of the condition. Common denials may arise from insufficient documentation or failure to specify the ulcer's location. Best practices include maintaining thorough clinical notes, ensuring that all relevant symptoms and diagnostic tests are documented, and using the appropriate CPT codes for any procedures performed in conjunction with the diagnosis.

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 K27.9?

K27.9 covers peptic ulcers that are not specified in terms of location within the gastrointestinal tract and are not associated with complications such as hemorrhage or perforation. It may include ulcers that are acute or chronic in nature.

When should K27.9 be used instead of related codes?

K27.9 should be used when the specific site of the peptic ulcer is unknown or unspecified, and there is no evidence of complications. If the ulcer is located in the stomach or duodenum and is documented, then K25 or K26 should be used respectively.

What documentation supports K27.9?

Documentation should include a clear diagnosis of a peptic ulcer, any relevant symptoms, and the absence of complications such as hemorrhage or perforation. Clinical notes, imaging results, and endoscopy findings can support the use of this code.