FY2027
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Excludes1 pair

K26- vs K63.1

K26 and K63.1 are not coded together. ICD-10-CM declares them mutually exclusive with an Excludes1 note — the two conditions are not expected to occur together, so exactly one of them is normally correct for a given encounter. The Official Guidelines carve out one exception: if the two conditions are clearly unrelated to each other, both may be reported.

The official note, declared on K63.1
perforation (nontraumatic) of duodenum (K26.-)
K26

Duodenal ulcer

Not billable
Chapter 11
Diseases of the digestive system
Section
K20-K31
Use when the record says
  • erosion (acute) of duodenum
  • duodenum ulcer (peptic)
  • postpyloric ulcer (peptic)
K63.1

Perforation of intestine (nontraumatic)

Billable
Chapter 11
Diseases of the digestive system
Section
K55-K64
Use when the record says
  • Perforation (nontraumatic) of rectum
Indexed under
  • Perforation, perforated › bowel
  • Perforation, perforated › colon
  • Perforation, perforated › ileum
  • Perforation, perforated › intestine NEC
  • Perforation, perforated › jejunum, jejunal

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