K60.4
K60.4: Rectal fistula
Non-billable headerICD-10-CM
K60.4 is a non-billable header ICD-10-CM code for rectal fistula. It cannot be billed on its own: choose one of the more specific child codes below.
Excludes1: never code together
These conditions cannot occur together. Billing both on the same encounter is a denial.
Code first
The underlying condition must be sequenced before this code.
Inclusion terms
Alternative wordings a physician may use in the chart for this same code.
- Fistula of rectum to skin
Other codes that can never be billed with K60.4
Their own Excludes1 notes name this code, so the conflict is not listed above.
- K62.6Ulcer of anus and rectum
Risk adjustment
No CMS-HCC V28 category: this code does not change a RAF score.
Medicare coverage
K60.4 is named in 4 Medicare coverage policies: 4 listing it as supporting medical necessity. Which one applies depends on your Medicare contractor.
- A59725Billing and Coding: Botulinum Toxins Injections
- A59727Billing and Coding: Botulinum Toxin Injections
- A59728Billing and Coding: Botulinum Toxin Injections
- A59808Billing and Coding: Botulinum Toxin Injections
Code history
- deletedFY2024-FY2027
Rectal fistula
Code to one of these instead K60.4
3 child codes. Green means billable.