K61.1 — Rectal abscess
K61.1 is a billable, specific ICD-10-CM code for rectal abscess. It is valid for submission on a claim.
Excludes1 — never code together
These conditions cannot occur together. Billing both on the same encounter is a denial.
- ischiorectal abscess (K61.39)
Inclusion terms
Alternative wordings a physician may use in the chart for this same code.
- Perirectal abscess
Risk adjustment
K61.1 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
K61.1 is named in 2 Medicare coverage policies — 2 listing it as supporting medical necessity. Which of them applies to you depends on your Medicare contractor, and coverage genuinely differs by state.
- A56421Billing and Coding: CT of the Abdomen and Pelvis
- A57427Billing and Coding: Transrectal Ultrasound
How K61.1 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 K61.1.
- Abscess›pararectal
- Abscess›perirectal
- Abscess›rectum
- Cellulitis›perirectal
- Cellulitis›rectum
- Abscess›intestine, intestinal NEC›rectal
Related codes at this level
Codes that share K61. If K61.1 is not quite right, the correct code is usually one of these.
Questions about K61.1
- Is K61.1 a billable ICD-10-CM code?
- Yes. K61.1 is a billable, specific ICD-10-CM code and is valid for submission on a claim.
- Where does K61.1 sit in the tabular list?
- Diseases of the digestive system (K00-K95), in the block Other diseases of intestines (K55-K64).
- What cannot be coded together with K61.1?
- K61.1 carries an Excludes1 note, which means the conditions it lists can never be coded together with it on the same encounter.