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2025 ICD-10-CM code K63.2

Fistula of the intestine.

Refer to the official ICD-10-CM coding guidelines for detailed instructions on the appropriate use of this code. Pay close attention to the "Excludes1" and "Excludes2" notes to ensure accurate coding.

Medical necessity for treatment of an intestinal fistula is established by the presence of symptoms or complications such as infection, pain, malnutrition, or bowel obstruction.The severity of the fistula and the potential for complications determine the need for intervention.

The clinical responsibility for this diagnosis involves identifying the location and extent of the fistula, determining its cause (if possible), managing associated symptoms (such as pain, infection, and malnutrition), and selecting the most appropriate treatment strategy (surgical repair, medical management, or a combination).

IMPORTANT:This code should not be used for fistulas of the duodenum (K31.6), fistulas associated with Crohn's disease (K50.013, K50.113, K50.813, K50.913), fistulas associated with ulcerative colitis (K51.013, K51.213, K51.313, K51.413, K51.513, K51.813, K51.913), fistulas of the anal and rectal regions (K60.-), appendiceal fistulas (K38.3), female intestinal-genital fistulas (N82.2-N82.4), or vesicointestinal fistulas (N32.1).

In simple words: This code describes an abnormal connection or tunnel between different parts of the intestine or between the intestine and the outside of the body.This is not the same as a fistula in the anus or rectum, or those linked to specific conditions like Crohn's disease.

K63.2, Fistula of intestine, is an ICD-10-CM code that classifies a fistula involving the intestine.A fistula is an abnormal connection between two organs or between an organ and the body surface.This code excludes fistulas of the duodenum, those associated with Crohn's disease or ulcerative colitis, fistulas of the anal and rectal regions, appendiceal fistulas, female intestinal-genital fistulas, and vesicointestinal fistulas.

Example 1: A patient presents post-abdominal surgery with symptoms of an intestinal fistula, such as drainage from a surgical wound, abdominal pain, and fever.Imaging studies confirm an enterocutaneous fistula., A patient with Crohn's disease develops an intestinal fistula between loops of bowel. This would not be coded as K63.2 due to its association with Crohn's., A patient with a history of diverticulitis experiences a perforation leading to a fistula. This would require a different code as it's associated with diverticulitis.

Detailed history of present illness, including onset, duration, and character of symptoms; physical examination findings; results of imaging studies (such as CT scan, MRI, or fistulography); laboratory results (such as complete blood count and inflammatory markers); and operative report if surgery was performed.

** Accurate coding requires careful consideration of the location of the fistula and any associated conditions.Consult with a coding specialist if there is uncertainty about the appropriate code selection.

** Only Enterprise users with EHR integration can access case-specific answers. Click here to request access.

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iFrame™ AI's knowledge is aligned with and limited to the materials uploaded by users and should not be interpreted as medical, legal, or any other form of advice by iFrame™.