Acute gastric ulcer with both hemorrhage and perforation

This code signifies a severe form of gastric ulceration characterized by both active bleeding and a full-thickness defect in the stomach wall. This dual complication represents an acute, life-threatening event requiring immediate medical and often surgical intervention.

Apply this code when documentation clearly indicates an acute gastric ulcer with evidence of both hemorrhage (e.g., hematemesis, melena, positive occult blood, significant drop in hemoglobin) and perforation (e.g., free air on imaging, peritonitis, surgical confirmation of a hole in the stomach). This diagnosis typically arises in emergency settings or during acute inpatient care.

• Ensure documentation explicitly states "acute" and confirms both hemorrhage and perforation are present. Do not assume both complications from general ulcer symptoms.
• Distinguish from chronic ulcers with acute exacerbation; this code is specific to acute onset.
• Sequence this code as the principal diagnosis when it is the primary reason for the admission or encounter.