2027 ICD-10-CM Diagnosis Code K60.523Anorectal fistula, complex, recurrent
ICD-10-CM Codes›K00–K95›K55-K64›K60
- Billable — Valid for Submission
- Not Chronic
K60.523 is a billable ICD-10-CM diagnosis code for anorectal fistula, complex, recurrent. 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 K60.523: its own notes plus those printed at K60.52, K60.5, 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.
- Anorectal fistula complex, occurring following complete healing
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 K60.523, its category, or a range that includes it.
Excludes1 1
These codes carry an Excludes1 note naming K60.523: they are not reported together with it, unless the two conditions are unrelated.
Excludes2 2
These codes carry an Excludes2 note naming K60.523: its condition is not part of those codes, and both may be reported when the patient has both.
Use Additional Code 3
These codes say to use an additional code from the note, and K60.523 is one of the codes named.
Index to Diseases and InjuriesGuidance
Alphabetical index entries that point to this code.
Clinical ClassificationClinical
AHRQ’s CCSR groups this code into broader clinical categories.
Clinical InformationClinical
Anorectal Fistula
a pathologic tract that connects an opening in the anal canal to the perianal skin. in the vast majority of cases there is a history of perianal abscess.
Patient EducationClinical
Anal Disorders
Your anus is the opening at the end of your large intestine. It is where stool (poop) leaves your body.
The full article covers:
- What is the anus?
- What are anal disorders?
- What are the symptoms of anal disorders?
- How are anal disorders diagnosed?
- How are anal disorders treated?
Read the full article at MedlinePlus
Courtesy of MedlinePlus, a service of the U.S. National Library of Medicine.
Code History & ChangesHistory
Replacement K60.523 replaces the following previously assigned code(s):
- K60.5 - Anorectal fistula
Questions About K60.523Overview
What is the ICD-10 code for anorectal fistula, complex, recurrent?
The ICD-10-CM code for anorectal fistula, complex, recurrent is K60.523 (sometimes written as K60523). It is billable on HIPAA-covered claims from October 1, 2026 through September 30, 2027.
Is K60.523 (Anorectal fistula, complex) a billable code?
Yes. This is a billable ICD-10-CM code, specific enough to report anorectal fistula, complex, recurrent on HIPAA-covered claims from October 1, 2026 through September 30, 2027.
What MS-DRG does K60.523 group to?
When anorectal fistula, complex, recurrent 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 K60.523 be reported with Q43.6?
Not as a rule. The Excludes1 note at K60.5, which applies to K60.523, 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).
