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Home/Diagnosis/ICD-10 Coding for Anal Fistula

ICD-10 Coding for Anal Fistula

K60.31
K60.32
K60.5

Complete ICD-10-CM coding and documentation guide for icd-10 coding for anal fistula includes clinical validation requirements, medical necessity guidelines, and coding policies.

Also Known as:
Fistula-in-ano
Perianal fistula
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Key Information: ICD-10 Coding for Anal Fistula

Essential facts and insights about ICD-10 Coding for Anal Fistula

Use ICD-10 code K60.31 for simple anal fistula, ensuring proper documentation in clinical notes.

Primary ICD-10-CM Codes

Simple anal fistula

Non-Billable
K60.31
Non-Billable

Diagnostic Criteria

  • • Fistula tract does not involve sphincter muscles

Applicable To

  • • Subcutaneous fistula

Important Notes

  • • Ensure documentation specifies the lack of sphincter involvement.

Complex anal fistula

Non-Billable
K60.32
Non-Billable

Diagnostic Criteria

  • • Use when the fistula tract involves sphincter muscles or has multiple tracts.

Applicable To

  • • Transsphincteric fistula
  • • Suprasphincteric fistula

Important Notes

  • • Ensure imaging confirms complexity.

Fistula with abscess

Non-Billable
K60.5
Non-Billable

Diagnostic Criteria

  • • Use when a fistula is accompanied by an abscess.

Applicable To

  • • Fistula-associated perianal abscess

Important Notes

  • • Document abscess culture results.
Ancillary Codes

Additional codes that may be used with this diagnosis

K61.1

Perianal abscess

Use when an abscess is present with the fistula.

Frequently Asked Questions

What is the ICD-10 code for a complex anal fistula?

The ICD-10 code for a complex anal fistula is K60.32, which covers fistulas involving sphincter muscles or multiple tracts.

How do you code an anal fistula with an abscess?

For an anal fistula with an abscess, use K60.5 and add K61.1 for the abscess if present.

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