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ICD-10 Guide
ICD-10 CodesK28.7

K28.7

Billable

Chronic gastrojejunal ulcer without hemorrhage or perforation

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

Code Description

ICD-10 K28.7 is a billable code used to indicate a diagnosis of chronic gastrojejunal ulcer without hemorrhage or perforation.

Key Diagnostic Point:

Chronic gastrojejunal ulcer without hemorrhage or perforation is a condition characterized by the presence of an ulcer in the gastrojejunal region, which is the junction between the stomach and the jejunum (the second part of the small intestine). Clinically, patients may present with symptoms such as abdominal pain, nausea, vomiting, and weight loss. The ulceration can result from various factors including chronic gastritis, excessive acid production, or complications from previous gastric surgeries such as gastric bypass. The anatomy involved includes the stomach, jejunum, and surrounding structures, which may be affected by the ulcer's presence. Disease progression can lead to complications if left untreated, although this specific code indicates that there is no hemorrhage or perforation at the time of diagnosis. Diagnostic considerations include endoscopy, imaging studies, and laboratory tests to rule out other gastrointestinal disorders. A thorough patient history and physical examination are essential for accurate diagnosis and management.

Code Complexity Analysis

Complexity Rating: Medium

Medium Complexity

Complexity Factors

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

Audit Risk Factors

  • Common coding errors include misclassification of ulcer type or severity.
  • Documentation gaps may arise from insufficient detail regarding the ulcer's chronicity or associated symptoms.
  • Billing challenges may occur if the condition is not clearly documented as chronic or if related procedures are not coded appropriately.

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

General Surgery

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

Chronic gastrojejunal ulcers can significantly impact patient quality of life and healthcare utilization. They may lead to increased hospital visits and interventions if not managed appropriately. Understanding the epidemiology of this condition can help healthcare providers implement preventive measures and improve patient outcomes. Quality measures related to gastrointestinal health often include monitoring for complications associated with ulcers, emphasizing the importance of accurate coding and documentation.

ICD-9 vs ICD-10

Chronic gastrojejunal ulcers can significantly impact patient quality of life and healthcare utilization. They may lead to increased hospital visits and interventions if not managed appropriately. Understanding the epidemiology of this condition can help healthcare providers implement preventive measures and improve patient outcomes. Quality measures related to gastrointestinal health often include monitoring for complications associated with ulcers, emphasizing the importance of accurate coding and documentation.

Reimbursement & Billing Impact

reimbursement.

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 K28.7?

K28.7 specifically covers chronic gastrojejunal ulcers that do not present with hemorrhage or perforation. It is important to differentiate this from acute ulcers or those with complications, which would require different coding.

When should K28.7 be used instead of related codes?

K28.7 should be used when the ulcer is confirmed to be chronic and located in the gastrojejunal area without any signs of bleeding or perforation. If the ulcer is acute or has complications, other codes should be selected.

What documentation supports K28.7?

Documentation should include a clear diagnosis of a chronic gastrojejunal ulcer, details of the patient's symptoms, any relevant imaging or endoscopic findings, and a treatment plan that reflects the chronic nature of the condition.