2026 ICD-10-CM Diagnosis Code K26.2Acute duodenal ulcer with both hemorrhage and perforation
ICD-10-CM Codes›K00–K95›K20-K31›K26
- Billable — Valid for Submission
- MCC — Major Complication or Comorbidity
- Risk Adjusts — HCC 78
- Not Chronic
K26.2 is a billable ICD-10-CM diagnosis code for acute duodenal ulcer with both hemorrhage and perforation. It is valid on HIPAA claims for fiscal year 2026 (October 1, 2025 through September 30, 2026) and groups to MS-DRG 377 through 379. As a secondary diagnosis, it counts as a major complication or comorbidity (MCC) and places an inpatient stay in the highest severity level of its MS-DRG family. It does not count, however, when the principal diagnosis is one of 76 closely related codes. In AHRQ's Clinical Classifications Software (CCSR), this diagnosis falls under Gastrointestinal hemorrhage.
For Medicare Advantage risk adjustment, K26.2 maps to CMS-HCC Category 78 (Intestinal Obstruction/Perforation) under the V28 model, adding a risk factor of about 0.326 for a community, non-dual, aged beneficiary in payment year 2026.
Code Identity
Code Classification
Medicare Risk Adjustment (HCC)Billing
K26.2 maps to a payment category in the CMS-HCC model used to risk-adjust Medicare Advantage payments. Weights are the published community factors for payment year 2026.
Source: CMS Payment Year 2026 risk adjustment mappings and model software. Weights are relative factors, not dollar amounts; a beneficiary's total RAF also includes demographics and interactions. Browse all CMS-HCC categories.
Approximate SynonymsGuidance
Alternate terms and clinical phrases that map to this code.
- Acute duodenal ulcer with hemorrhage
- Acute duodenal ulcer with hemorrhage AND obstruction
- Acute duodenal ulcer with hemorrhage AND perforation
- Acute duodenal ulcer with hemorrhage AND with perforation but without obstruction
- Acute duodenal ulcer with hemorrhage but without obstruction
- Acute duodenal ulcer with hemorrhage, with perforation AND with obstruction
- Acute duodenal ulcer with obstruction
- Acute duodenal ulcer with perforation
- Acute duodenal ulcer with perforation AND obstruction
- Acute duodenal ulcer with perforation but without obstruction
- Acute peptic ulcer with hemorrhage AND obstruction
- Acute peptic ulcer with hemorrhage, with perforation AND with obstruction
- Acute peptic ulcer with perforation AND obstruction
- Duodenal ulcer with hemorrhage AND obstruction
- Duodenal ulcer with hemorrhage AND perforation
- Duodenal ulcer with hemorrhage AND with perforation but without obstruction
- Duodenal ulcer with hemorrhage but without obstruction
- Duodenal ulcer with hemorrhage, with perforation AND with obstruction
- Duodenal ulcer with perforation AND obstruction
- Duodenal ulcer with perforation but without obstruction
Index to Diseases and InjuriesGuidance
Alphabetical index entries that point to this code.
Clinical ClassificationClinical
AHRQ’s CCSR groups this code into broader clinical categories.
Clinical InformationClinical
Duodenal Ulcer
a peptic ulcer located in the duodenum.
Patient EducationClinical
Gastrointestinal Bleeding
Your digestive or gastrointestinal (GI) tract includes the esophagus, stomach, small intestine, large intestine or colon, rectum, and anus. Bleeding can come from any of these areas. The amount of bleeding can be so small that only a lab test can find it.
Read the full article at MedlinePlus
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Convert K26.2 to ICD-9-CMHistory
The closest ICD-9-CM equivalents under the General Equivalence Mappings.
Code HistoryHistory
Questions About K26.2Overview
What is the ICD-10 code for acute duodenal ulcer with both hemorrhage and perforation?
The ICD-10-CM code for acute duodenal ulcer with both hemorrhage and perforation is K26.2 (sometimes written as K262). It is billable on HIPAA-covered claims from October 1, 2025 through September 30, 2026.
Is K26.2 (Duodenal ulcer) a billable code?
Yes. This is a billable ICD-10-CM code, specific enough to report acute duodenal ulcer with both hemorrhage and perforation on HIPAA-covered claims from October 1, 2025 through September 30, 2026.
What MS-DRG does K26.2 group to?
When acute duodenal ulcer with both hemorrhage and perforation is the principal diagnosis on an inpatient stay, it groups to MS-DRG 377, 378, 379, with relative weights from 0.6304 to 1.8280 depending on complications. Higher weights mean higher Medicare reimbursement.
Is K26.2 a CC or MCC?
CMS lists K26.2 as an MCC (major complication or comorbidity) for FY 2026. Reported as a secondary diagnosis, it places the inpatient stay in the highest-weighted DRG of its severity family. It does not count when the principal diagnosis is one of the 76 closely related codes in its exclusion list.
What is the ICD-9 equivalent of K26.2?
Under the General Equivalence Mappings, acute duodenal ulcer with both hemorrhage and perforation converts to ICD-9-CM 532.20 (ac duoden ulc w hem/perf). The mapping is approximate, so confirm the match fits the documentation.
What HCC is K26.2?
K26.2 (acute duodenal ulcer with both hemorrhage and perforation) maps to CMS-HCC Category 78 (Intestinal Obstruction/Perforation), commonly written as HCC 78, in the CMS-HCC V28 model used for Medicare Advantage risk adjustment in payment year 2026. It mapped to HCC 33 under the retired V24 model. It also maps in the PACE (CMS-HCC V22), ESRD (V21), and ESRD (V24) models. It does not map to any RxHCC in the Part D prescription drug model.
Does K26.2 risk-adjust for Medicare Advantage payment?
Yes. When documented and reported on a Medicare Advantage encounter, K26.2 adds a risk adjustment factor of about 0.326 to the beneficiary's RAF score for a community, non-dual, aged enrollee (published V28 weights range from 0.326 to 0.688 depending on the payment segment). A more severe related category (HCC 77) supersedes it when both are reported. See the full factor table on the HCC 78 category page.
