M25.18 — Fistula, other specified site
Is M25.18 billable?
Yes, but M25.18 is an unspecified code. M25.18 is a valid, billable ICD-10-CM code for encounters from October 1, 2026 through September 30, 2027. However, M25.18 is an unspecified or catch-all code. Payers apply additional scrutiny to unspecified codes and many deny them when the medical record supports a more specific option, so check the documentation before selecting M25.18 — the more specific alternatives are listed below.
M25.18 at a glance
| Code | M25.18 |
|---|---|
| Description | Fistula, other specified site |
| Billable | Yes |
| Code set | ICD-10-CM FY2027 |
| Valid for encounters | October 1, 2026 – September 30, 2027 |
Which MS-DRGs does M25.18 group to?
M25.18 sits in MDC 08 and helps define the logic of 2 MS-DRGs (version 44, FY2027). Which one a stay actually groups to also depends on procedures and secondary diagnoses.
- 555Signs and Symptoms of Musculoskeletal System and Connective Tissue with MCCmedical
- 556Signs and Symptoms of Musculoskeletal System and Connective Tissue without MCCmedical
How is M25.18 listed in the Alphabetic Index?
These are the routes through the Alphabetic Index that lead to M25.18. They show the wording a clinician may have documented, which often differs from the Tabular description.
- Fistula › joint › specified joint NEC (cutaneous)
- Fistula › joint › vertebrae (cutaneous)
Inclusion terms
Alternative wording in documentation that is classified to M25.18.
- Fistula, vertebrae
Excludes2 — not included here — inherited from Chapter 13
The conditions below are not part of M25.18, but a patient may have both at the same time. When documentation supports it, M25.18 and the excluded code may both be reported.
- arthropathic psoriasis (L40.5-)
- certain conditions originating in the perinatal period (P04-P96)
- certain infectious and parasitic diseases (A00-B99)
- compartment syndrome (traumatic) (T79.A-)
- 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 M20-M25
The conditions below are not part of M25.18, but a patient may have both at the same time. When documentation supports it, M25.18 and the excluded code may both be reported.
- joints of the spine (M40-M54)
Excludes2 — not included here — inherited from M25
The conditions below are not part of M25.18, but a patient may have both at the same time. When documentation supports it, M25.18 and the excluded code may both be reported.
How long has M25.18 existed?
M25.18 has been in ICD-10-CM since at least FY2016, the earliest fiscal year on record here.
Derived from the official order files for FY2016–FY2026. FY2017 and FY2020 publish no order file, so those years are not covered.