Gastroenterology Coding Alert

Reviewed on May 13, 2015   Question: Which diagnosis code should I use to report Cameron’s ulcers? I believe these are ulcers in the hiatal hernia. Because the gastroenterology and pathology reports do not refer to these as “gastric ulcers,” I have been filing 537.89 (Other specified disorders of stomach and duodenum). I chose this code because it includes “intestinal metaplasia of gastric mucosa.” Is there a better code to report? Colorado Subscriber         Answer: Cameron’s ulcers are found in the hiatal hernia and are considered gastric ulcers. Use the appropriate five-digit ICD-9 code for gastric ulcer, 531.xx. The fourth digit (531.0-531.9) will be based on the appearance of the ulcer (with hemorrhage, with perforation, without hemorrhage and perforation, etc.) as described by the gastroenterologist. The fifth digit will be 0 (without mention of obstruction) or 1 (with obstruction). Under ICD-10, you will report the category K25.-, Gastric ulcer.  You may also list the symptoms or signs, such as indigestion (536.8) or heartburn (787.1), reported to the gastroenterologist as indications for the procedure. The ICD-10 equivalents for these symptoms are K30 and R12, respectively.