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Home/Diagnosis/ICD-10 Coding for Fistula

ICD-10 Coding for Fistula

K60.421
T81.82

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

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

Essential facts and insights about ICD-10 Coding for Fistula

Use ICD-10 code K60.421 for rectal fistula, complex, persistent, ensuring proper documentation in clinical notes.

Primary ICD-10-CM Codes

Rectal fistula, complex, persistent

Billable Code
K60.421
Billable

Diagnostic Criteria

  • • Presence of a complex and persistent fistula confirmed by imaging

Applicable To

  • • Complex persistent rectal fistula

Important Notes

  • • Ensure documentation specifies 'complex' and 'persistent' to use this code.

Persistent postprocedural fistula

Non-Billable
T81.82
Non-Billable

Diagnostic Criteria

  • • Documentation of persistence post-surgery
  • • Surgical notes indicating fistula development

Applicable To

  • • Persistent fistula following surgery

Important Notes

  • • Ensure persistence is clearly documented post-surgery.
Ancillary Codes

Additional codes that may be used with this diagnosis

K61.1

Rectal abscess

Use when an abscess is present alongside the fistula.

Frequently Asked Questions

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

The ICD-10 code for a complex rectal fistula is K60.421, which requires documentation of complexity and persistence.

How do you code a postprocedural fistula?

For a persistent postprocedural fistula, use ICD-10 code T81.82, ensuring persistence is documented.

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