Rectal fistula, simple, persistent
ICD-10 K60.412 is a billable code used to indicate a diagnosis of rectal fistula, simple, persistent.
K60.412 refers to a simple, persistent rectal fistula, which is an abnormal connection between the rectum and the skin or another organ. Clinically, patients may present with symptoms such as persistent drainage of fecal matter, recurrent infections, and discomfort in the anal region. The anatomy involved typically includes the rectum, anal canal, and surrounding tissues. Disease progression can vary; while some fistulas may resolve spontaneously, persistent cases often require surgical intervention. Diagnostic considerations include a thorough clinical examination, imaging studies such as MRI or endoscopy, and possibly a fistulogram to assess the extent and complexity of the fistula. Accurate diagnosis is crucial as it influences treatment options and potential complications, including abscess formation or chronic inflammation.
Standard ICD-10-CM documentation requirements apply
Various clinical presentations within this specialty area
Follow specialty-specific billing guidelines
Standard ICD-10-CM documentation requirements apply
Various clinical presentations within this specialty area
Follow specialty-specific billing guidelines
K60.412 covers simple rectal fistulas that are persistent, meaning they have not healed over time and continue to cause symptoms. This includes fistulas that may arise from previous surgeries, inflammatory bowel disease, or trauma.
K60.412 should be used when the rectal fistula is confirmed to be simple and persistent. If the fistula is acute or complicated by abscess or other factors, different codes such as K60.41 or K60.43 should be considered.
Documentation should include a detailed clinical history, physical examination findings, imaging results, and any previous treatments attempted. Surgical notes and follow-up assessments are also critical for supporting the diagnosis.
