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Home/Diagnosis/ICD-10 Coding for Anorectal Fistula

ICD-10 Coding for Anorectal Fistula

K60.41
K60.422

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

Also Known as:
Rectal Fistula
Anal Fistula
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Key Information: ICD-10 Coding for Anorectal Fistula

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

Use ICD-10 code K60.41 for simple rectal fistula, ensuring proper documentation in clinical notes.

Primary ICD-10-CM Codes

Simple rectal fistula

Non-Billable
K60.41
Non-Billable

Diagnostic Criteria

  • • Fistula does not involve significant sphincter muscle.

Applicable To

  • • Simple anorectal fistula

Important Notes

  • • Ensure documentation specifies 'simple' to avoid misclassification.

Complex persistent rectal fistula

Billable Code
K60.422
Billable

Diagnostic Criteria

  • • Use when the fistula is complex and persistent, involving significant sphincter muscle.

Applicable To

  • • Persistent anorectal fistula

Important Notes

  • • Ensure complexity and persistence are well-documented.
Ancillary Codes

Additional codes that may be used with this diagnosis

K61.1

Rectal abscess

Use when an abscess is present with the fistula.

B96.20

Unspecified Escherichia coli as the cause of diseases classified elsewhere

Use when E. coli is identified in cultures.

Frequently Asked Questions

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

The ICD-10 code for a complex anorectal fistula is K60.422, which indicates a persistent fistula with significant sphincter involvement.

How do you code a simple anorectal fistula?

A simple anorectal fistula is coded as K60.41, which applies when the fistula does not involve significant sphincter muscle.

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