K60.421 Rectal fistula, complex, initial

Billable ICD-10-CM code, FY2026.

Applicable to

• Rectal fistula, complex, new

Applies from K60 Fissure and fistula of anal and rectal regions

Excludes1 (never code together)

• fissure and fistula of anal and rectal regions with abscess or cellulitis (K61.-)

Excludes2 (not included here)

• abscess or cellulitis of anal and rectal regions (K61.-)
• anal sphincter tear (healed) (nontraumatic) (old) (K62.81)

Applies from K60.4 Rectal fistula

Applicable to

• Fistula of rectum to skin

Excludes1 (never code together)

• congenital fistula (Q43.6)
• rectovaginal fistula (N82.3)
• vesicorectal fistual (N32.1)

Code first

• , if applicable:
• Crohn's disease (K50.-)
• ulcerative colitis (K51.-)

Applies from K60.42 Rectal fistula, complex

Applicable to

• Extrasphincteric rectal fistula
• High intersphincteric rectal fistula
• Suprasphincteric rectal fistula
• Transsphincteric rectal fistula

Code also

• , if applicable:
• perianal abscess (K61.0)
• rectovaginal fistula (N82.3)
• stenosis of anus and rectum (K62.4)

MS-DRG index

Defines the logic of DRG(s) 393-395 in MDC 06.

Code annotations containing back-references to K60.421

Back-references to K60.4

• Use Additional: K50 Crohn's disease [regional enteritis] ("rectal fistula (K60.4-)")
• Use Additional: K51 Ulcerative colitis ("rectal fistula (K60.4-)")

Back-references to K60

• Type 1 Excludes: K62.6 Ulcer of anus and rectum ("fissure and fistula of anus and rectum (K60.-)")
• Type 2 Excludes: K62.81 Anal sphincter tear (healed) (nontraumatic) (old) ("anal fissure (K60.-)")
• Type 2 Excludes: K63.2 Fistula of intestine ("fistula of anal and rectal regions (K60.-)")

Diagnosis Index entries for K60.421

• Fistula (cutaneous) › rectal (infectional) › complex › initial
• Fistula (cutaneous) › rectal (infectional) › complex › new

Nearby codes

• K60.411 Rectal fistula, simple, initial
• K60.412 Rectal fistula, simple, persistent
• K60.413 Rectal fistula, simple, recurrent
• K60.419 Rectal fistula, simple, unspecified
• K60.42 Rectal fistula, complex
• K60.421 Rectal fistula, complex, initial (this code)
• K60.422 Rectal fistula, complex, persistent
• K60.423 Rectal fistula, complex, recurrent
• K60.429 Rectal fistula, complex, unspecified
• K60.5 Anorectal fistula
• K60.50 Anorectal fistula, unspecified