2027 ICD-10-CM Diagnosis Code N36.0Urethral fistula
ICD-10-CM Codes›N00–N99›N30-N39›N36
- Billable — Valid for Submission
- CC — Complication or Comorbidity
- Chronic Condition
N36.0 is a billable ICD-10-CM diagnosis code for urethral fistula. It is valid on HIPAA claims for fiscal year 2027 (October 1, 2026 through September 30, 2027) and groups to MS-DRG 698 through 700. As a secondary diagnosis, it counts as a complication or comorbidity (CC) and moves an inpatient stay to a higher severity level within its MS-DRG family. It does not count, however, when the principal diagnosis is one of 123 closely related codes. In AHRQ's Clinical Classifications Software (CCSR), this diagnosis falls under Other specified and unspecified diseases of bladder and urethra.
Code Identity
Code Classification
Approximate SynonymsGuidance
Alternate terms and clinical phrases that map to this code.
- Acquired urethral fistula
- Acquired urethrocutaneous fistula
- Intestinourinary fistula
- Multiple urethrocutaneous fistulae
- Perineal fistula
- Rectourinary fistula
- Schistosomal urethral fistula
- Schistosomiasis of urethra
- Urethral fistula
- Urethral fistula to skin
- Urethroperineal fistula
- Urethrorectal fistula
- Urinary fistula
- Urinary schistosomiasis
Instructional NotesGuidance
Instructions from the official ICD-10-CM Tabular List that apply to N36.0: its own notes plus those printed at block N30-N39 and Chapter 14. 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.
- Urethroperineal fistula
- Urethrorectal fistula
- Urinary fistula NOS
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)
Source: CMS ICD-10-CM Tabular List. How to read instructional notes.
Index to Diseases and InjuriesGuidance
Alphabetical index entries that point to this code.
rectourethral N36.0
urethra N36.0
urethroperineal N36.0
urethrorectal N36.0
Clinical ClassificationClinical
AHRQ’s CCSR groups this code into broader clinical categories.
Clinical InformationClinical
Urethral Fistula
an abnormal communication between the urethra and another organ or anatomic site.
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.
Read the full article at MedlinePlus
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Convert N36.0 to ICD-9-CMHistory
The closest ICD-9-CM equivalents under the General Equivalence Mappings.
Code HistoryHistory
Questions About N36.0Overview
What is the ICD-10 code for urethral fistula?
The ICD-10-CM code for urethral fistula is N36.0 (sometimes written as N360). It is billable on HIPAA-covered claims from October 1, 2026 through September 30, 2027.
Is N36.0 (Other disorders of urethra) a billable code?
Yes. This is a billable ICD-10-CM code, specific enough to report urethral fistula on HIPAA-covered claims from October 1, 2026 through September 30, 2027.
What MS-DRG does N36.0 group to?
When urethral fistula is the principal diagnosis on an inpatient stay, it groups to MS-DRG 699, 698, 700, with relative weights from 0.6740 to 1.6400 depending on complications. Higher weights mean higher Medicare reimbursement.
Is N36.0 a CC or MCC?
CMS lists N36.0 as a CC (complication or comorbidity) for FY 2027. Reported as a secondary diagnosis, it moves the inpatient stay to a higher-weighted DRG within its severity family. It does not count when the principal diagnosis is one of the 123 closely related codes in its exclusion list.
Can N36.0 be reported with N50.89?
Not as a rule. The Excludes1 note on N36.0 lists "urethroscrotal fistula (N50.89)". 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).
