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 CodesChapter 11: Diseases of the digestive systemK61

K61

Non-billable

Abscess of anal and rectal regions

Chapter 11:Diseases of the digestive system

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

Code Description

ICD-10 K61 is a used to indicate a diagnosis of abscess of anal and rectal regions.

Key Diagnostic Point:

K61 refers to abscesses located in the anal and rectal regions, which are localized collections of pus resulting from infection. Clinically, patients may present with symptoms such as pain, swelling, redness, and tenderness around the anus or rectum. The anatomy involved includes the anal canal, rectum, and surrounding soft tissues, which can become inflamed and infected due to various factors, including anal fissures, inflammatory bowel disease, or obstruction of anal glands. Disease progression can lead to the formation of a more extensive abscess if left untreated, potentially resulting in systemic symptoms like fever and malaise. Diagnostic considerations include a thorough physical examination, imaging studies (such as ultrasound or MRI), and sometimes laboratory tests to identify the causative organism. Prompt diagnosis and treatment are essential to prevent complications such as fistula formation or sepsis.

Code Complexity Analysis

Complexity Rating: Medium

Medium Complexity

Complexity Factors

  • Diagnostic complexity: Requires clinical evaluation and sometimes imaging.
  • Treatment complexity: May involve surgical drainage and antibiotic therapy.
  • Documentation requirements: Detailed clinical notes and imaging results needed.
  • Coding specificity: Requires accurate identification of the abscess location and any associated conditions.

Audit Risk Factors

  • Common coding errors: Misidentifying the location or type of abscess.
  • Documentation gaps: Incomplete clinical notes regarding symptoms and treatment.
  • Billing challenges: Potential denials if the medical necessity is not clearly documented.

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 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 K61 lies in its potential to cause severe discomfort and complications if not treated promptly. Abscesses in the anal and rectal regions can lead to increased healthcare utilization, including emergency visits and surgical interventions. Understanding the epidemiology of these conditions helps in developing preventive strategies and improving patient outcomes. Quality measures may include tracking the incidence of abscesses and the effectiveness of treatment protocols.

ICD-9 vs ICD-10

The clinical significance of K61 lies in its potential to cause severe discomfort and complications if not treated promptly. Abscesses in the anal and rectal regions can lead to increased healthcare utilization, including emergency visits and surgical interventions. Understanding the epidemiology of these conditions helps in developing preventive strategies and improving patient outcomes. Quality measures may include tracking the incidence of abscesses and the effectiveness of treatment protocols.

Reimbursement & Billing Impact

Reimbursement considerations include the complexity of the procedure performed, the setting (inpatient vs. outpatient), and the payer's specific guidelines. Common denials may arise from insufficient documentation of the medical necessity for the procedure or failure to provide adequate follow-up care notes. Best practices include ensuring that all clinical notes are complete and that the rationale for the chosen treatment is clearly articulated.

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 K61?

K61 covers various types of anal and rectal abscesses, including perianal abscesses, ischiorectal abscesses, and intersphincteric abscesses. Each type has distinct clinical features and may require different management approaches.

When should K61 be used instead of related codes?

K61 should be used when there is a confirmed diagnosis of an abscess in the anal or rectal region. It is important to differentiate it from K62 codes, which may pertain to other anal conditions without abscess formation.

What documentation supports K61?

Documentation should include a detailed history and physical examination, imaging studies if performed, treatment plans, and follow-up notes. Evidence of infection and the specific location of the abscess should be clearly stated.