Q42.0 Congenital absence, atresia and stenosis of rectum with fistula

Billable ICD-10-CM code, FY2026. Acts as a Complication or Comorbidity (CC) as a secondary diagnosis. Exempt from present-on-admission (POA) reporting.

Applies from Q42 Congenital absence, atresia and stenosis of large intestine

Includes

• congenital obstruction, occlusion and stricture of large intestine

Risk adjustment (HCC)

• CMS-HCC V28: HCC 78 — Intestinal Obstruction/Perforation

MS-DRG index

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

Approximate ICD-9-CM (GEMs)

• 751.2 Atresia and stenosis of large intestine, rectum, and anal canal (approximate)

Code annotations containing back-references to Q42.0

Back-references to Q42.0

• Type 1 Excludes: Q43.6 Congenital fistula of rectum and anus ("congenital fistula of rectum with absence, atresia and stenosis (Q42.0)")

Back-references to Q42

• Type 1 Excludes: K56 Paralytic ileus and intestinal obstruction without hernia ("congenital stricture or stenosis of intestine (Q41-Q42)")

Diagnosis Index entries for Q42.0

• Absence (of) (organ or part) (complete or partial) › rectum (congenital) › with fistula
• Agenesis › rectum › with fistula
• Atresia, atretic › rectum › with fistula
• Fistula (cutaneous) › rectum (to skin) › congenital › with absence, atresia and stenosis
• Hypoplasia, hypoplastic › rectum › with fistula
• Imperforate (congenital) › rectum › with fistula
• Impervious (congenital) › rectum › with fistula
• Stricture › rectum (sphincter) › congenital › with fistula

Nearby codes

• Q42 Congenital absence, atresia and stenosis of large intestine
• Q42.0 Congenital absence, atresia and stenosis of rectum with fistula (this code)
• Q42.1 Congenital absence, atresia and stenosis of rectum without fistula
• Q42.2 Congenital absence, atresia and stenosis of anus with fistula
• Q42.3 Congenital absence, atresia and stenosis of anus without fistula
• Q42.8 Congenital absence, atresia and stenosis of other parts of large intestine
• Q42.9 Congenital absence, atresia and stenosis of large intestine, part unspecified