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ICD-10 Guide
ICD-10 CodesK61.39

K61.39

Billable

Other ischiorectal abscess

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

Code Description

ICD-10 K61.39 is a billable code used to indicate a diagnosis of other ischiorectal abscess.

Key Diagnostic Point:

K61.39 refers to other ischiorectal abscesses, which are localized collections of pus that occur in the ischiorectal fossa, an anatomical space located between the ischium and the rectum. These abscesses can arise from various causes, including infection of anal glands, trauma, or inflammatory bowel disease. Clinically, patients may present with symptoms such as severe perianal pain, swelling, fever, and difficulty with bowel movements. The condition can progress if not treated promptly, potentially leading to systemic infection or complications such as fistula formation. Diagnosis typically involves a thorough clinical examination, imaging studies like ultrasound or MRI, and sometimes laboratory tests to identify the causative organism. Treatment usually requires surgical intervention to drain the abscess and may include antibiotics to address the underlying infection. Follow-up care is essential to monitor for recurrence or complications.

Code Complexity Analysis

Complexity Rating: Medium

Medium Complexity

Complexity Factors

  • Diagnostic complexity: Requires clinical evaluation and imaging for accurate diagnosis.
  • Treatment complexity: Involves surgical procedures and potential complications.
  • Documentation requirements: Detailed clinical notes and imaging reports are necessary.
  • Coding specificity: Requires precise coding to differentiate from other abscess types.

Audit Risk Factors

  • Common coding errors: Misclassification with other abscess codes.
  • Documentation gaps: Incomplete clinical notes regarding symptoms and treatment.
  • Billing challenges: Denials may occur if documentation does not support the necessity of surgical intervention.

Specialty Focus

Medical Specialties

Primary medical specialty: General 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

Secondary 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

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 K61.39 lies in its potential to cause severe complications if left untreated, impacting patient quality of life and healthcare utilization. Ischiorectal abscesses can lead to increased hospital admissions and surgical interventions, contributing to overall healthcare costs. Understanding the epidemiology of this condition helps in developing preventive strategies and improving patient outcomes in the population.

ICD-9 vs ICD-10

The clinical significance of K61.39 lies in its potential to cause severe complications if left untreated, impacting patient quality of life and healthcare utilization. Ischiorectal abscesses can lead to increased hospital admissions and surgical interventions, contributing to overall healthcare costs. Understanding the epidemiology of this condition helps in developing preventive strategies and improving patient outcomes in the population.

Reimbursement & Billing Impact

reimbursement and minimize audit risks.

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 K61.39?

K61.39 covers ischiorectal abscesses that are not classified elsewhere, including those resulting from infections, trauma, or inflammatory conditions affecting the anal region.

When should K61.39 be used instead of related codes?

K61.39 should be used when the abscess is specifically located in the ischiorectal area and is not adequately described by other codes, such as those for perianal or rectal abscesses.

What documentation supports K61.39?

Documentation should include clinical findings, imaging results, treatment plans, and any surgical notes that detail the nature of the abscess and the interventions performed.