K26.0 vs R58
K26.0 and R58 can never be reported together. ICD-10-CM declares them mutually exclusive with an Excludes1 note, meaning the two conditions cannot occur in the same patient — so exactly one of them is correct for any given encounter.
The official note, declared on R58
acute duodenal ulcer with hemorrhage (K26.0)
K26.0
Acute duodenal ulcer with hemorrhage
Billable
- Chapter 11
- Diseases of the digestive system
- Section
- K20-K31
Indexed under
- Ulcer, ulcerated, ulcerating, ulceration, ulcerative › duodenum, duodenal › acute › with › hemorrhage
R58
Hemorrhage, not elsewhere classified
BillableUnspecified
- Chapter 18
- Symptoms, signs and abnormal clinical and laboratory findings, not elsewhere classified
- Section
- R50-R69
Use when the record says
- Hemorrhage NOS
Indexed under
- Ecchymosis
- Hemorrhage, hemorrhagic (concealed)
- Extravasation › blood
- Hemorrhage, hemorrhagic › abdomen (concealed)
- Hemorrhage, hemorrhagic › artery (concealed)
These two codes sit in different chapters of the Tabular List, which is usually the clearest signal that they describe different underlying processes rather than different degrees of the same one.
Excludes1 is not always absolute: where two conditions covered by the note are genuinely unrelated, CMS guidance permits reporting both. Document the reasoning rather than assuming it. More on Excludes1 vs Excludes2 · FY2027