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The coding for this scenario would be as follows: Primary code: K26.2 (because the type of ulcer is duodenal and it is acute with hemorrhage and perforation) Secondary code: F10.231 (because she exhibits alcohol dependence with withdrawal delirium) Tertiary code: Y90.3 (because of the range of her blood alcohol level is 60-79 mg/100 ml) This is how you think in an ICD-10 world

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The most common locations for an oral melanotic macule include vermillion border of the lips, buccal mucosa, and palate

Also, the gallbladder was normal in configuration with no stone or wall thickening (Fig