K60.412 — Rectal fistula, simple, persistent
K60.412 is a billable, specific ICD-10-CM code for rectal fistula, simple, persistent. It is valid for submission on a claim.
Inclusion terms
Alternative wordings a physician may use in the chart for this same code.
- Rectal fistula, simple, chronic
Risk adjustment
K60.412 does not map to an HCC and does not risk-adjust under CMS-HCC V28. That is normal — most ICD-10 codes do not. It still needs to be coded correctly; it just will not move a RAF score.
Medicare coverage
K60.412 is named in 9 Medicare coverage policies — 9 listing it as supporting medical necessity. Which of them applies to you depends on your Medicare contractor, and coverage genuinely differs by state.
- A56632Billing and Coding: Colonoscopy/Sigmoidoscopy/Proctosigmoidoscopy
- A57185Billing and Coding: Botulinum Toxin Injections
- A57186Billing and Coding: Botulinum Toxin Injections
- A57427Billing and Coding: Transrectal Ultrasound
How K60.412 is indexed
Coders do not find codes by browsing the tabular list — they look them up in the alphabetic index, under the word the physician wrote. These are the index entries that lead here, so you can see which chart wordings map to K60.412.
- Fistula›rectal›simple›chronic
- Fistula›rectal›simple›persistent
Related codes at this level
Codes that share K60.41. If K60.412 is not quite right, the correct code is usually one of these.
Questions about K60.412
- Is K60.412 a billable ICD-10-CM code?
- Yes. K60.412 is a billable, specific ICD-10-CM code and is valid for submission on a claim.
- Where does K60.412 sit in the tabular list?
- Diseases of the digestive system (K00-K95), in the block Other diseases of intestines (K55-K64).