ICD-10 Logo
ICDxICD-10 Medical Coding
ICD-10 Logo
ICDxICD-10 Medical Coding
ICD 10 CodesDiagnoses
ICD 10 CodesDiagnoses
ICD-10 Logo
ICDxICD-10 Medical Coding

Comprehensive ICD-10-CM code reference with AI-powered search capabilities.

© 2025 ICD Code Compass. All rights reserved.

Browse

  • All Chapters
  • All Categories
  • Diagnoses

Tools

  • AI Code Search
ICD-10-CM codes are maintained by the CDC and CMS. This tool is for reference purposes only.
v1.0.0
ICD-10 Guide
ICD-10 CodesK60.519

K60.519

Billable

Anorectal fistula, simple, unspecified

BILLABLE STATUSYes
IMPLEMENTATION DATEOctober 1, 2015
LAST UPDATED09/06/2025

Code Description

ICD-10 K60.519 is a billable code used to indicate a diagnosis of anorectal fistula, simple, unspecified.

Key Diagnostic Point:

Anorectal fistula, simple, unspecified (K60.519) refers to an abnormal connection between the anal canal and the perianal skin, which can result from various causes, including previous abscesses, inflammatory bowel disease, or trauma. Clinically, patients may present with symptoms such as pain, swelling, and discharge from the anal region. The anatomy involved includes the anal canal, rectum, and surrounding soft tissues. Disease progression can lead to recurrent infections, abscess formation, and complications if left untreated. Diagnosis typically involves a thorough clinical examination, possibly supplemented by imaging studies such as MRI or endoscopy to assess the fistula's extent and any associated complications. Accurate diagnosis is crucial for determining the appropriate surgical intervention, which may range from simple fistulotomy to more complex procedures depending on the fistula's characteristics and associated conditions.

Code Complexity Analysis

Complexity Rating: Medium

Medium Complexity

Complexity Factors

  • Diagnostic complexity: Requires careful assessment to differentiate from other anorectal conditions.
  • Treatment complexity: Surgical options vary based on fistula type and patient health.
  • Documentation requirements: Detailed clinical notes are essential for accurate coding.
  • Coding specificity: Limited to simple, unspecified cases; more specific codes exist for complex cases.

Audit Risk Factors

  • Common coding errors: Misclassification of fistula complexity.
  • Documentation gaps: Incomplete clinical notes may lead to incorrect coding.
  • Billing challenges: Potential denials if documentation does not support the diagnosis.

Specialty Focus

Medical Specialties

Primary medical specialty: Gastroenterology

Documentation Requirements

Standard ICD-10-CM documentation requirements apply

Common Clinical Scenarios

Various clinical presentations within this specialty area

Billing Considerations

Follow specialty-specific billing guidelines

Secondary specialty: Colorectal Surgery

Documentation Requirements

Standard ICD-10-CM documentation requirements apply

Common Clinical Scenarios

Various clinical presentations within this specialty area

Billing Considerations

Follow specialty-specific billing guidelines

Related ICD-10 Codes

Related CPT Codes

CPT Code

Clinical Scenario

Documentation Requirements

CPT Code

Clinical Scenario

Documentation Requirements

CPT Code

Clinical Scenario

Documentation Requirements

ICD-10 Impact

Diagnostic & Documentation Impact

Enhanced Specificity

ICD-10 Improvements

The clinical significance of K60.519 lies in its potential to affect patient quality of life due to pain and discomfort associated with anorectal fistulas. Population health impact includes the need for surgical interventions, which can lead to increased healthcare utilization. Quality measures may focus on the successful management of fistulas to prevent complications and improve patient outcomes. Epidemiologically, the incidence of anorectal fistulas varies, with certain populations, such as those with inflammatory bowel disease, being at higher risk.

ICD-9 vs ICD-10

The clinical significance of K60.519 lies in its potential to affect patient quality of life due to pain and discomfort associated with anorectal fistulas. Population health impact includes the need for surgical interventions, which can lead to increased healthcare utilization. Quality measures may focus on the successful management of fistulas to prevent complications and improve patient outcomes. Epidemiologically, the incidence of anorectal fistulas varies, with certain populations, such as those with inflammatory bowel disease, being at higher risk.

Reimbursement & Billing Impact

Reimbursement considerations include the complexity of the procedure performed and the patient's overall health status. Common denials may arise from insufficient documentation or misclassification of the fistula's complexity. Adhering to coding best practices, such as using the most specific code available and ensuring that all documentation aligns with the billed services, can help mitigate these challenges.

Resources

Clinical References

  • •
    ICD-10 Official Guidelines for K00-K99
  • •
    Clinical Documentation Requirements

Coding & Billing References

  • •
    ICD-10 Official Guidelines for K00-K99
  • •
    Clinical Documentation Requirements

Frequently Asked Questions

What specific conditions are covered by K60.519?

K60.519 covers simple anorectal fistulas that do not have associated complications or specific anatomical details. It is used when the fistula's characteristics are not clearly defined or documented.

When should K60.519 be used instead of related codes?

K60.519 should be used when the fistula is classified as simple and unspecified. If the fistula is complex or has specific anatomical features, more specific codes such as K60.51 should be utilized.

What documentation supports K60.519?

Documentation should include a detailed clinical assessment, description of symptoms, any imaging studies performed, and the rationale for the diagnosis of a simple anorectal fistula.