Gastroenterology Coding Alert

Question: After a laparoscopic gastrojejunostomy, the patient returned a few weeks later complaining of abdominal pain. There was no bleeding in the upper gastrointestinal (GI) tract, but during the endoscopic exam, the doctor diagnosed the patient with a gastrojejunal ulcer.

Which code is appropriate for this diagnosis?

AAPC Forum Participant

Answer: Gastrojejunal ulcers can sometimes occur after gastric surgical procedures are performed. When properly coding a gastrojejunal ulcer, your primary concern will be whether there is a hemorrhage or perforation present, as well as if the condition is acute or chronic.

To code this condition correctly, you’ll look to the K28.- (Gastrojejunal ulcer) section of the ICD-10-CM code set.

After the practitioner identifies the presence or absence of a hemorrhage and perforation, you’ll have to choose from the following codes based on the medical record:

• K28.0 (Acute gastrojejunal ulcer with hemorrhage)
• K28.1 (… with perforation)
• K28.2 (… with both hemorrhage and perforation)
• K28.3 (… without hemorrhage or perforation)
• K28.4 (Chronic or unspecified gastrojejunal ulcer with hemorrhage)
• K28.5 (… with perforation)
• K28.6 (… with both hemorrhage and perforation)
• K28.7 (Chronic gastrojejunal ulcer without hemorrhage or perforation)
• K28.9 (Gastrojejunal ulcer, unspecified as acute or chronic, without hemorrhage or perforation)

If the doctor’s notes don’t contain enough information to choose a specific code, you’ll need to either use K28.9 or query them for more details.

Lindsey Bush, BA, MA, CPC, Production Editor, AAPC