Congenital absence, atresia and stenosis of rectum with fistula
ICD-10 Q42.0 is a billable code used to indicate a diagnosis of congenital absence, atresia and stenosis of rectum with fistula.
Congenital absence, atresia, and stenosis of the rectum with fistula is a serious congenital malformation of the digestive system characterized by the incomplete development of the rectum, leading to an absence or blockage of the rectal passage. This condition often presents with a fistula, which is an abnormal connection between the rectum and another organ, typically the urinary tract or vagina. Infants with this condition may exhibit signs of bowel obstruction, abdominal distension, and failure to pass meconium within the first 24 hours of life. Diagnosis is typically confirmed through imaging studies and physical examination. Surgical intervention is often required to correct the malformation and establish normal bowel function. This condition is part of a broader category of congenital malformations affecting the digestive system, which includes esophageal atresia, Hirschsprung disease, and imperforate anus, each presenting unique challenges in diagnosis and management.
Pediatric documentation must include detailed birth history, physical examination findings, and any imaging studies performed.
Common scenarios include newborns presenting with failure to pass meconium, abdominal distension, and signs of bowel obstruction.
Coders should be aware of the need for accurate coding of associated congenital anomalies and the potential for multiple surgical interventions.
Genetic documentation should include family history, genetic testing results, and any syndromic associations.
Scenarios may involve genetic counseling for families with a history of congenital malformations.
Consideration of chromosomal abnormalities that may be associated with congenital malformations is essential for accurate coding.
Used during surgical intervention for rectal atresia with fistula.
Operative report detailing the procedure and findings.
Pediatric surgical documentation must include age-specific considerations.
Common surgical interventions for Q42.0 include colostomy, rectal pull-through procedures, and repair of associated fistulas. The choice of procedure depends on the specific anatomy and associated anomalies present.
