Gastroenterology Coding Alert

Question: After a gastrojejunostomy, the patient returned complaining of abdominal pain. There was no bleeding in the upper GI tract, but during the endoscopic exam, the doctor diagnosed the patient with a gastrojejunal ulcer. Which code is appropriate for this diagnosis?

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Answer: Gastrojejunal ulcers occur sometimes after surgical partial gastric removal. When reporting a diagnosis of gastrojejunal ulcer, you’ll need to focus only on presence or absence of hemorrhage or perforation along with chronicity, but you won’t need to know whether an obstruction was involved.

To start on your coding journey, you’ll look to the K28.- (Gastrojejunal ulcer) section of the ICD-10 code set.

You’ll then have to further expand K28 to identify the presence or absence of hemorrhage and perforation, which means you’ll have to scour the medical record to get more details. Based on

hemorrhage and perforation, you’ll have to choose from the following nine expansions to K28:

• 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)

Depending on the information you find in the patient’s record, you’ll select the most appropriate code from this list. If the physician does not provide enough details to select a code, you’ll have to report K28.9 or query the provider.