Acute gastrojejunal ulcer w both hemorrhage and perforation

This code signifies an acutely developed ulcer located at the surgical anastomosis between the stomach and jejunum, presenting simultaneously with active bleeding and a full-thickness defect through the ulcer wall. This is a severe complication typically following gastric surgery, such as a gastrectomy or gastrojejunostomy.

Apply this code when documentation clearly indicates an acute gastrojejunal ulcer with concurrent hemorrhage and perforation. This typically occurs in patients with a history of gastric surgery who present with acute abdominal pain, signs of gastrointestinal bleeding (e.g., hematemesis, melena), and evidence of peritonitis or free air on imaging.

• Ensure documentation specifies "acute" and both "hemorrhage" and "perforation" are present.
• Distinguish from chronic ulcers or ulcers with only one complication (hemorrhage or perforation).
• Sequence this code as the principal diagnosis when it is the primary reason for the encounter.