2025 ICD-10-CM code K60.5
(Active) Effective Date: N/A Revision Date: N/A Deletion Date: N/A Diseases of the digestive system - Other diseases of intestines Chapter 12: Diseases of the digestive system Feed
Anorectal fistula is a connection between the rectum or anus and the skin near the anus.
Surgical intervention is medically necessary when conservative measures fail to resolve symptoms and complications arise.Medical necessity for surgical repair is documented based on clinical findings and the patient's response to less-invasive treatments.Justification should include patient history, examination, and a clinical rationale for surgery.
The clinical responsibility for managing an anorectal fistula falls primarily on a colorectal surgeon or general surgeon.The physician's duties include diagnosing the condition through physical examination and imaging (if necessary), and deciding on the appropriate treatment plan, which might range from conservative management to surgery. Post-operative care also falls under their responsibility.
In simple words: An anorectal fistula is an abnormal tunnel that connects the rectum or anus to the skin around the anus. This can cause pain, swelling, and drainage, and might be due to infection or other conditions. Doctors often treat this with surgery.
An anorectal fistula is an abnormal channel connecting the rectum or anus to the skin near the anus.It can result from a variety of causes, including infection, trauma, or Crohn's disease.Symptoms may include pain, swelling, drainage, and recurrent abscesses.Diagnosis typically involves physical examination and sometimes imaging studies. Treatment may involve surgical intervention or other medical management depending on the severity and cause.
Example 1: A 45-year-old male presents with recurrent perianal abscesses and a palpable tract.Physical examination confirms an anorectal fistula.Surgery is planned to excise the fistula tract., A 32-year-old female with Crohn's disease develops an anorectal fistula as a complication.Medical management, including medication to control inflammation, is attempted before considering surgery., A 60-year-old male with a history of anal surgery develops a fistula.Imaging studies reveal the location and extent of the fistula, guiding surgical planning and approach.
Detailed history of presenting symptoms (pain, drainage, swelling, etc.),physical examination findings including location and size of the fistula, results of imaging studies if performed (fistulogram, MRI, CT), and details of the surgical procedure performed and pathology report if applicable.Pre and post-operative notes are vital for accurate coding.
** The appropriate code should reflect the specific type of anorectal fistula and associated conditions, as further specified in the ICD-10-CM manual.Always cross-reference with other relevant codes to ensure accurate billing and to avoid coding errors.
- Payment Status: Active
- Specialties:Colorectal Surgery, General Surgery
- Place of Service:Office, Hospital (Inpatient and Outpatient), Ambulatory Surgical Center