FY2026 · AprilSelected edition
Effective from
- Inherited rules changed
Anorectal fistula, simple, initial
Billable diagnosis code
CDC/NCHS · FY2026 · Aprilcongenital fistula (Q43.6)
Coverage depends on the payer, service and applicable policy. A billable code does not guarantee payment.
For US diagnosis claims covered by HIPAA, ICD-10-CM is required from October 1, 2015.
Use the service date for outpatient/professional claims and the discharge date for hospital inpatient claims. Earlier encounters use ICD-9-CM; each individual code must also be valid for the applicable date.
Official coding guidelines → · CMS ↗Grouping depends on the complete encounter and CMS grouper logic.
2026-04-01 – 2026-09-30
CMS · MS-DRG 43.1First observed · 2024-10-01
Latest recorded change · FY2026 · April
Effective from
Anorectal fistula, simple, initial
Billable diagnosis code
CDC/NCHS · FY2026 · April| All editions | Effective from | Code history |
|---|---|---|
| FY2025 | 2024-10-01 | Added |
| FY2025 · 04-01 | 2025-04-01 | No tabular change |
| FY2026 | 2025-10-01 | No tabular change |
| FY2026 · April | 2026-04-01 | Inherited rules changed |
| FY2027 | 2026-10-01 | No tabular change |
Anorectal fistula, simple, new
congenital fistula (Q43.6)
Historical assignments from the CDC conversion table support data retrieval. They do not authorize substituting a previous code for the current code.
Previous assignment: K60.5
Other entries in the same category; these are not automatic substitutes.
| Code | Description | Category · further specificity required |
|---|---|---|
| K60.512 | Anorectal fistula, simple, persistent | Billable / specific |
| K60.513 | Anorectal fistula, simple, recurrent | Billable / specific |
| K60.519 | Anorectal fistula, simple, unspecified | Billable / specific |
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