K60.42 — Rectal fistula, complex
Is K60.42 billable?
No — K60.42 is a non-billable header code. K60.42 groups more specific codes and cannot be submitted on a claim. A valid ICD-10-CM code must be reported at the highest level of specificity available in its branch. Select one of the 4 billable codes beneath K60.42.
K60.42 at a glance
| Code | K60.42 |
|---|---|
| Description | Rectal fistula, complex |
| Billable | No — header code |
| Code set | ICD-10-CM FY2027 |
| Valid for encounters | October 1, 2026 – September 30, 2027 |
How is K60.42 listed in the Alphabetic Index?
These are the routes through the Alphabetic Index that lead to K60.42. They show the wording a clinician may have documented, which often differs from the Tabular description.
- Fistula › rectal › extrasphincteric (cutaneous)
- Fistula › rectal › high intersphincteric (cutaneous)
- Fistula › rectal › suprasphincteric (cutaneous)
- Fistula › rectal › transsphincteric (cutaneous)
Code also
Two codes may be needed to describe the condition fully. Whether K60.42 is sequenced first depends on the reason for the encounter.
Inclusion terms
Alternative wording in documentation that is classified to K60.42.
- Extrasphincteric rectal fistula
- High intersphincteric rectal fistula
- Suprasphincteric rectal fistula
- Transsphincteric rectal fistula
Excludes1 — never code together — inherited from K60.4
The conditions below can never be reported together with K60.42 on the same claim. An Excludes1 note means the two conditions cannot occur in the same patient, so reporting both is a coding error.
Code first — inherited from K60.4
The underlying condition below must be sequenced before K60.42. K60.42 describes a manifestation and cannot be the principal or first-listed diagnosis.
Excludes2 — not included here — inherited from Chapter 11
The conditions below are not part of K60.42, but a patient may have both at the same time. When documentation supports it, K60.42 and the excluded code may both be reported.
- certain conditions originating in the perinatal period (P04-P96)
- certain infectious and parasitic diseases (A00-B99)
- complications of pregnancy, childbirth and the puerperium (O00-O9A)
- congenital malformations, deformations and chromosomal abnormalities (Q00-Q99)
- endocrine, nutritional and metabolic diseases (E00-E88)
- injury, poisoning and certain other consequences of external causes (S00-T88)
- neoplasms (C00-D49)
- symptoms, signs and abnormal clinical and laboratory findings, not elsewhere classified (R00-R94)
Excludes2 — not included here — inherited from K60
The conditions below are not part of K60.42, but a patient may have both at the same time. When documentation supports it, K60.42 and the excluded code may both be reported.
What codes fall under K60.42? (4)
How long has K60.42 existed?
K60.42 first appears in FY2025.
Derived from the official order files for FY2016–FY2026. FY2017 and FY2020 publish no order file, so those years are not covered.