K26.3 — Acute duodenal ulcer without hemorrhage or perforation
K26.3 is a billable, specific ICD-10-CM code for acute duodenal ulcer without hemorrhage or perforation. It is valid for submission on a claim.
Risk adjustment
K26.3 does not map to an HCC and does not risk-adjust under CMS-HCC V28. That is normal — most ICD-10 codes do not. It still needs to be coded correctly; it just will not move a RAF score.
Medicare coverage
K26.3 is named in 4 Medicare coverage policies — 4 listing it as supporting medical necessity. Which of them applies to you depends on your Medicare contractor, and coverage genuinely differs by state.
- A56389Billing and Coding: Upper Gastrointestinal Endoscopy and Visualization
- A56421Billing and Coding: CT of the Abdomen and Pelvis
- A57063Billing and Coding: Diagnostic and Therapeutic Esophagogastroduodenoscopy
- A57414Billing and Coding: Upper Gastrointestinal Endoscopy (Diagnostic and Therapeutic)
How K26.3 is indexed
Coders do not find codes by browsing the tabular list — they look them up in the alphabetic index, under the word the physician wrote. These are the index entries that lead here, so you can see which chart wordings map to K26.3.
- Ulcer, ulcerated, ulcerating, ulceration, ulcerative›duodenum, duodenal›acute
Related codes at this level
Codes that share K26. If K26.3 is not quite right, the correct code is usually one of these.
- K26.0Acute duodenal ulcer with hemorrhage
- K26.1Acute duodenal ulcer with perforation
- K26.2Acute duodenal ulcer with both hemorrhage and perforation
- K26.4Chronic or unspecified duodenal ulcer with hemorrhage
- K26.5Chronic or unspecified duodenal ulcer with perforation
- K26.6Chronic or unspecified duodenal ulcer with both hemorrhage and perforation
- K26.7Chronic duodenal ulcer without hemorrhage or perforation
- K26.9Duodenal ulcer, unspecified as acute or chronic, without hemorrhage or perforation
Questions about K26.3
- Is K26.3 a billable ICD-10-CM code?
- Yes. K26.3 is a billable, specific ICD-10-CM code and is valid for submission on a claim.
- Where does K26.3 sit in the tabular list?
- Diseases of the digestive system (K00-K95), in the block Diseases of esophagus, stomach and duodenum (K20-K31).