2026 ICD-10-CM Diagnosis Code K60.411Rectal fistula, simple, initial

ICD-10-CM Codes›K00–K95›K55-K64›K60

ICD-10-CM K60.411
CMSSource: CMS FY 2026 ICD-10-CM dataset · Effective Oct 1, 2025 – Sep 30, 2026

K60.411 is a billable ICD-10-CM diagnosis code for rectal fistula, simple, initial. It is valid on HIPAA claims for fiscal year 2026 (October 1, 2025 through September 30, 2026) and groups to MS-DRG 393 through 395. In AHRQ's Clinical Classifications Software (CCSR), this diagnosis falls under Anal and rectal conditions.

Code Identity

ICD-10-CM Code
K60.411
Billable Status
Yes — Valid for Submission
Code Describes
Rectal fistula, simple, initial
Short Description
Rectal fistula, simple, initial
Same as the full description in the CMS dataset.
Parent Code
K60.41
Rectal fistula, simple

Code Classification

ChapterK00–K95Diseases of the digestive system
SectionK55-K64Other diseases of intestines
CategoryK60Fissure and fistula of anal and rectal regions
This CodeK60.411Rectal fistula, simple, initial

Tabular List NotesGuidance

Coding notes and annotation back-references applicable to this code.

Inclusion Terms

  • Rectal, fistula, simple, new

Index to Diseases and InjuriesGuidance

Alphabetical index entries that point to this code.

External Cause of Injuries IndexGuidance

References for this code in the External Cause of Injuries Index.

    • Fistula(cutaneous)
      • rectal (infectional)
        • simple
          • initial
    • Fistula(cutaneous)
      • rectal (infectional)
        • simple
          • new

Clinical ClassificationClinical

AHRQ’s CCSR groups this code into broader clinical categories.

CCSR DIG015
Anal and rectal conditions
Default principal diagnosis: inpatient Yes · outpatient Yes

Code History & ChangesHistory

Replacement K60.411 replaces the following previously assigned code(s):

  • K60.4 - Rectal fistula
FY 2025AddedAdded to the ICD-10-CM code setEffective October 1, 2024.
FY 2026CurrentCurrent code set, no changesEffective October 1, 2025 through September 30, 2026.

Questions About K60.411Overview

Is K60.411 (Rectal fistula, simple) a billable code?

Yes. This is a billable ICD-10-CM code, specific enough to report rectal fistula, simple, initial on HIPAA-covered claims from October 1, 2025 through September 30, 2026.

What MS-DRG does K60.411 group to?

When rectal fistula, simple, initial is the principal diagnosis on an inpatient stay, it groups to MS-DRG 393, 394, 395, with relative weights from 0.6490 to 1.5993 depending on complications. Higher weights mean higher Medicare reimbursement.

Footnotes

[1] Not chronic - A diagnosis code that does not fit the criteria for chronic condition (duration, ongoing medical treatment, and limitations) is considered not chronic. Some codes designated as not chronic are acute conditions. Other diagnosis codes that indicate a possible chronic condition, but for which the duration of the illness is not specified in the code description (i.e., we do not know the condition has lasted 12 months or longer) also are considered not chronic.