Acute gastrojejunal ulcer with perforation

This code signifies a newly developed ulcer located at the surgical connection between the stomach and jejunum, which has progressed to a full-thickness defect through the gastrointestinal wall. This perforation allows gastric or jejunal contents to leak into the abdominal cavity, leading to peritonitis. It represents an acute, life-threatening complication of gastrojejunal ulceration.

Use this code when documentation clearly indicates an acute ulcer at the gastrojejunal anastomosis with evidence of perforation, such as free air on imaging or direct visualization during surgery. This typically occurs in patients with a history of gastric bypass or gastrectomy. Supporting documentation will include operative reports, imaging studies, and physician notes detailing the acute onset and perforated status.

• Differentiate from chronic gastrojejunal ulcers, which would be coded differently even if perforated.
• Ensure the documentation specifies "acute" and "perforation" at the gastrojejunal site; otherwise, a less specific ulcer code may be more appropriate.
• Always sequence this code as the principal diagnosis if it is the reason for the admission and treatment.