2027 ICD-10-CM Diagnosis Code K60.422Rectal fistula, complex, persistent
ICD-10-CM Codes›K00–K95›K55-K64›K60
- Billable — Valid for Submission
- Not Chronic
K60.422 is a billable ICD-10-CM diagnosis code for rectal fistula, complex, persistent. It is valid on HIPAA claims for fiscal year 2027 (October 1, 2026 through September 30, 2027) 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
Code Classification
Instructional NotesGuidance
Instructions from the official ICD-10-CM Tabular List that apply to K60.422: its own notes plus those printed at K60.42, K60.4, K60, and Chapter 11. A note printed at a category, block or chapter applies to every code under it.
Applicable To
Conditions this code is used for: synonyms of the title or, for "other specified" codes, the conditions assigned to it. The list is not exhaustive.
- Rectal fistula, complex, chronic
Excludes1
Not coded here: the excluded code is never reported together with this one, unless the two conditions are unrelated.
Excludes2
Not included here: the excluded condition is not part of this code, but a patient may have both, so both codes may be reported.
- certain conditions originating in the perinatal period (P04-P96)
- certain infectious and parasitic diseases (A00-B99)
- complications of pregnancy, childbirth and the puerperium (O00-O9A)
- congenital malformations, deformations and chromosomal abnormalities (Q00-Q99)
- endocrine, nutritional and metabolic diseases (E00-E88)
- injury, poisoning and certain other consequences of external causes (S00-T88)
- neoplasms (C00-D49)
- symptoms, signs and abnormal clinical and laboratory findings, not elsewhere classified (R00-R94)
Code First
The underlying condition named in the note is sequenced before this code.
Code Also
A second code may be needed to fully describe the condition; the note gives no sequencing direction.
Source: CMS ICD-10-CM Tabular List. How to read instructional notes.
Referenced in Other NotesGuidance
Instructional notes printed at other codes that name K60.422, its category, or a range that includes it.
Excludes1 1
These codes carry an Excludes1 note naming K60.422: they are not reported together with it, unless the two conditions are unrelated.
Excludes2 2
These codes carry an Excludes2 note naming K60.422: its condition is not part of those codes, and both may be reported when the patient has both.
Use Additional Code 2
These codes say to use an additional code from the note, and K60.422 is one of the codes named.
Index to Diseases and InjuriesGuidance
Alphabetical index entries that point to this code.
chronic K60.422
persistent K60.422
Clinical ClassificationClinical
AHRQ’s CCSR groups this code into broader clinical categories.
Clinical InformationClinical
Rectal Fistula
an abnormal anatomical passage connecting the rectum to the outside, with an orifice at the site of drainage.
Patient EducationClinical
Fistulas
A fistula is an abnormal connection between two parts inside of the body. Fistulas may develop between different organs, such as between the esophagus and the windpipe or the bowel and the vagina. They can also develop between two blood vessels, such as between an artery and a vein or between two arteries.
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Code History & ChangesHistory
Replacement K60.422 replaces the following previously assigned code(s):
- K60.4 - Rectal fistula
Questions About K60.422Overview
What is the ICD-10 code for rectal fistula, complex, persistent?
The ICD-10-CM code for rectal fistula, complex, persistent is K60.422 (sometimes written as K60422). It is billable on HIPAA-covered claims from October 1, 2026 through September 30, 2027.
Is K60.422 (Rectal fistula, complex) a billable code?
Yes. This is a billable ICD-10-CM code, specific enough to report rectal fistula, complex, persistent on HIPAA-covered claims from October 1, 2026 through September 30, 2027.
What MS-DRG does K60.422 group to?
When rectal fistula, complex, persistent is the principal diagnosis on an inpatient stay, it groups to MS-DRG 394, 395, 393, with relative weights from 0.6379 to 1.5877 depending on complications. Higher weights mean higher Medicare reimbursement.
Can K60.422 be reported with Q43.6?
Not as a rule. The Excludes1 note at K60.4, which applies to K60.422, lists "congenital fistula (Q43.6)". An Excludes1 note means the excluded code is never reported together with this one; the only exception is when the two conditions are unrelated to each other (Official Guidelines, Section I.A.12.a).
