K60.423
K60.423: Rectal fistula, complex, recurrent
Billable / specific codeICD-10-CM
K60.423 is a billable, specific ICD-10-CM code for rectal fistula, complex, recurrent. It is valid for submission on a claim.
Check K60.423 with the rest of the claim: free scrubberInclusion terms
Alternative wordings a physician may use in the chart for this same code.
- Rectal fistula complex occurring following complete healing
Excludes1 inherited from the categories above K60.423
A category’s note binds every code beneath it.
Excludes2 inherited from the categories above K60.423
Not part of this code, but both may be coded when both are present.
Other codes that can never be billed with K60.423
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
K60.423 is named in 9 Medicare coverage policies: 9 listing it as supporting medical necessity. Which one applies depends on your Medicare contractor.
- A56632Billing and Coding: Colonoscopy/Sigmoidoscopy/Proctosigmoidoscopy
- A57185Billing and Coding: Botulinum Toxin Injections
- A57186Billing and Coding: Botulinum Toxin Injections
- A57427Billing and Coding: Transrectal Ultrasound
Alphabetic index entries that lead here
- Fistula›rectal›complex›occurring following complete healing
- Fistula›rectal›complex›recurrent
Code history
- addedFY2024-FY2027
Rectal fistula, complex, recurrent