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ICD-10 Guide
ICD-10 CodesChapter 11: Diseases of the digestive systemK27

K27

Non-billable

Peptic ulcer, site unspecified

Chapter 11:Diseases of the digestive system

BILLABLE STATUSNo
IMPLEMENTATION DATEOctober 1, 2015
LAST UPDATED09/05/2025

Code Description

ICD-10 K27 is a used to indicate a diagnosis of peptic ulcer, site unspecified.

Key Diagnostic Point:

The ICD-10 code K27 refers to peptic ulcers that are unspecified in site, which means that the exact location of the ulcer within the gastrointestinal tract is not identified. Peptic ulcers can occur in various locations, including the stomach (gastric ulcers) and the upper part of the small intestine (duodenal ulcers). This category encompasses ulcers that may be symptomatic or asymptomatic, and it is crucial for healthcare providers to recognize the potential complications associated with peptic ulcers, such as bleeding, perforation, and obstruction. The unspecified nature of this code indicates that further investigation may be needed to determine the precise location and underlying causes of the ulceration.

  • Clinically, the management of peptic ulcers often involves a combination of medication, lifestyle modifications, and in some cases, surgical intervention. The use of K27 is significant in clinical documentation and coding practices, as it allows for the identification of patients who may require further diagnostic evaluation or treatment. It is important for healthcare providers to ensure that they are using this code appropriately, as it can impact patient care pathways and reimbursement processes. Accurate coding is essential for tracking the prevalence of peptic ulcers and understanding their impact on population health.

Code Complexity Analysis

Complexity Rating: Medium

Medium Complexity

Complexity Factors

  • Variability in presentation
  • Need for further diagnostic testing
  • Potential for complications

Audit Risk Factors

  • Inadequate documentation
  • Misclassification of ulcer type
  • Failure to capture complications

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 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

The clinical impact of the K27 code category is significant, as it helps identify patients at risk for complications associated with peptic ulcers, such as gastrointestinal bleeding or perforation. By accurately coding and documenting these cases, healthcare providers can contribute to quality measures aimed at improving patient outcomes. Furthermore, understanding the prevalence of unspecified peptic ulcers can inform public health initiatives and resource allocation within healthcare systems.
From an administrative perspective, the use of K27 can influence healthcare trends, particularly in relation to the management of gastrointestinal disorders. Tracking the incidence of peptic ulcers can provide insights into the effectiveness of treatment protocols and the need for further research into preventive measures. As healthcare continues to evolve, the implications of coding practices like K27 will play a crucial role in shaping the future of patient care and health policy.

ICD-9 vs ICD-10

The clinical impact of the K27 code category is significant, as it helps identify patients at risk for complications associated with peptic ulcers, such as gastrointestinal bleeding or perforation. By accurately coding and documenting these cases, healthcare providers can contribute to quality measures aimed at improving patient outcomes. Furthermore, understanding the prevalence of unspecified peptic ulcers can inform public health initiatives and resource allocation within healthcare systems. From an administrative perspective, the use of K27 can influence healthcare trends, particularly in relation to the management of gastrointestinal disorders. Tracking the incidence of peptic ulcers can provide insights into the effectiveness of treatment protocols and the need for further research into preventive measures. As healthcare continues to evolve, the implications of coding practices like K27 will play a crucial role in shaping the future of patient care and health policy.

Reimbursement & Billing Impact

Reimbursement considerations may vary based on the patient's insurance plan and the specific services rendered. It is advisable to follow up with payers to understand their requirements for claims involving peptic ulcers, especially when the site is unspecified. Proper coding and documentation can help avoid claim denials and ensure timely reimbursement for services provided.

Resources

Clinical References

  • •
    Official ICD-10 Guidelines for K27

Coding & Billing References

  • •
    Official ICD-10 Guidelines for K27

Frequently Asked Questions

What conditions are included in K27?

K27 includes peptic ulcers that do not specify the site of occurrence, which may involve ulcers in the stomach or duodenum that are not clearly identified.

When should I use K27 codes?

K27 should be used when a patient presents with a peptic ulcer and the specific site of the ulcer is not documented or known. It is important to use this code when further diagnostic evaluation is pending.

What documentation is required for K27?

Documentation should include a clear indication of the patient's symptoms, any diagnostic tests performed, and the clinical rationale for using the unspecified code. Additional notes on the patient's treatment plan and follow-up may also be beneficial.