K60.529

K60.529: Anorectal fistula, complex, unspecified

Billable / specific codeICD-10-CM

K60.529 is a billable, specific ICD-10-CM code for anorectal fistula, complex, unspecified. It is valid for submission on a claim.

Check K60.529 with the rest of the claim: free scrubber

Excludes1 inherited from the categories above K60.529

A category’s note binds every code beneath it.

Written on K60.5: Anorectal fistula

congenital fistula (Q43.6)

Excludes2 inherited from the categories above K60.529

Not part of this code, but both may be coded when both are present.

Written on K60: Fissure and fistula of anal and rectal regions

abscess or cellulitis of anal and rectal regions (K61.-)
anal sphincter tear (healed) (nontraumatic) (old) (K62.81)

Other codes that can never be billed with K60.529

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

K60.529 is named in 8 Medicare coverage policies: 8 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
A59707Billing and Coding: Botulinum Toxin Injections

Alphabetic index entries that lead here

Fistula›anorectal›complex

Code history

addedFY2024-FY2027
Anorectal fistula, complex, unspecified