K60.421 — Rectal fistula, complex, initial
Is K60.421 billable?
Yes — K60.421 is billable for FY2027. K60.421 is a valid, billable ICD-10-CM code at the highest level of specificity in its branch. K60.421 may be submitted for encounters from October 1, 2026 through September 30, 2027.
K60.421 at a glance
| Code | K60.421 |
|---|---|
| Description | Rectal fistula, complex, initial |
| Billable | Yes |
| Code set | ICD-10-CM FY2027 |
| Valid for encounters | October 1, 2026 – September 30, 2027 |
Which MS-DRGs does K60.421 group to?
K60.421 sits in MDC 06 and helps define the logic of 3 MS-DRGs (version 44, FY2027). Which one a stay actually groups to also depends on procedures and secondary diagnoses.
- 393Other Digestive System Diagnoses with MCCmedical
- 394Other Digestive System Diagnoses with CCmedical
- 395Other Digestive System Diagnoses without CC/MCCmedical
How is K60.421 listed in the Alphabetic Index?
These are the routes through the Alphabetic Index that lead to K60.421. They show the wording a clinician may have documented, which often differs from the Tabular description.
- Fistula › rectal › complex › initial (cutaneous)
- Fistula › rectal › complex › new (cutaneous)
Inclusion terms
Alternative wording in documentation that is classified to K60.421.
- Rectal fistula, complex, new
Excludes1 — never code together — inherited from K60.4
The conditions below can never be reported together with K60.421 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 K60.421. K60.421 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 K60.421, but a patient may have both at the same time. When documentation supports it, K60.421 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 K60.421, but a patient may have both at the same time. When documentation supports it, K60.421 and the excluded code may both be reported.
Code also — inherited from K60.42
Two codes may be needed to describe the condition fully. Whether K60.421 is sequenced first depends on the reason for the encounter.
How long has K60.421 existed?
K60.421 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.