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  6. 2024 ICD-10-CM Code M25.16
Version 2024
Non-Billable Code

2024 ICD-10-CM Diagnosis Code M25.16

Fistula, knee

ICD-10-CM Code:
M25.16
ICD-10 Code for:
Fistula, knee
Is Billable?
Not Valid for Submission
Code Navigator:

Code Classification

  • Diseases of the musculoskeletal system and connective tissue
    (M00–M99)
    • Other joint disorders
      (M20-M25)
      • Other joint disorder, not elsewhere classified
        (M25)

M25.16 is a non-specific and non-billable diagnosis code code, consider using a code with a higher level of specificity for a diagnosis of fistula, knee. The code is not specific and is NOT valid for the year 2024 for the submission of HIPAA-covered transactions. Category or Header define the heading of a category of codes that may be further subdivided by the use of 4th, 5th, 6th or 7th characters.

Specific Coding Applicable to Fistula, knee

Non-specific codes like M25.16 require more digits to indicate the appropriate level of specificity. Consider using any of the following ICD-10-CM codes with a higher level of specificity when coding for fistula, knee:

  • Use M25.161 for Fistula, right knee - BILLABLE CODE

  • Use M25.162 for Fistula, left knee - BILLABLE CODE

  • Use M25.169 for Fistula, unspecified knee - BILLABLE CODE

Index to Diseases and Injuries References

The following annotation back-references for this diagnosis code are found in the injuries and diseases index. The Index to Diseases and Injuries is an alphabetical listing of medical terms, with each term mapped to one or more ICD-10-CM code(s).

Patient Education


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.

Some people are born with a fistula. Other common causes of fistulas include:

  • Complications from surgery
  • Injury
  • Infection
  • Diseases, such as Crohn's disease or ulcerative colitis

Treatment depends on the cause of the fistula, where it is, and how bad it is. Some fistulas will close on their own. In some cases, you may need antibiotics and/or surgery.


[Learn More in MedlinePlus]

Knee Injuries and Disorders

Your knee joint is made up of bone, cartilage, ligaments and fluid. Muscles and tendons help the knee joint move. When any of these structures is hurt or diseased, you have knee problems. Knee problems can cause pain and difficulty walking.

Knee problems are very common, and they occur in people of all ages. Knee problems can interfere with many things, from participation in sports to simply getting up from a chair and walking. This can have a big impact on your life.

The most common disease affecting the knee is osteoarthritis. The cartilage in the knee gradually wears away, causing pain and swelling.

Injuries to ligaments and tendons also cause knee problems. A common injury is to the anterior cruciate ligament (ACL). You usually injure your ACL by a sudden twisting motion. ACL and other knee injuries are common sports injuries.

Treatment of knee problems depends on the cause. In some cases your doctor may recommend knee replacement.

NIH: National Institute of Arthritis and Musculoskeletal and Skin Diseases


[Learn More in MedlinePlus]

Code History

  • FY 2024 - No Change, effective from 10/1/2023 through 9/30/2024
  • FY 2023 - No Change, effective from 10/1/2022 through 9/30/2023
  • FY 2022 - No Change, effective from 10/1/2021 through 9/30/2022
  • FY 2021 - No Change, effective from 10/1/2020 through 9/30/2021
  • FY 2020 - No Change, effective from 10/1/2019 through 9/30/2020
  • FY 2019 - No Change, effective from 10/1/2018 through 9/30/2019
  • FY 2018 - No Change, effective from 10/1/2017 through 9/30/2018
  • FY 2017 - No Change, effective from 10/1/2016 through 9/30/2017
  • FY 2016 - New Code, effective from 10/1/2015 through 9/30/2016. This was the first year ICD-10-CM was implemented into the HIPAA code set.