Chronic or unsp duodenal ulcer w both hemorrhage and perf

This diagnosis code signifies a long-standing or unconfirmed duodenal ulcer that has simultaneously caused both bleeding and a full-thickness defect in the duodenal wall. It indicates a severe and complicated presentation of peptic ulcer disease affecting the first part of the small intestine.

Apply this code when documentation clearly states a chronic or unspecified duodenal ulcer with concurrent hemorrhage (e.g., melena, hematemesis, positive occult blood) and perforation (e.g., free air on imaging, peritonitis, surgical confirmation). This code is appropriate when both complications are actively present or being treated.

• Ensure documentation explicitly states both hemorrhage and perforation; if only one is present, a different code is required.
• Distinguish between acute and chronic ulcers; this code covers chronic or when chronicity is not specified.
• Do not use this code if the hemorrhage or perforation is due to a cause other than the duodenal ulcer itself.