K60.1 is not a CMS-HCC payment code. MEAT criteria · RAF Calculator · free HCC coding tools

ICD-10-CM Code View

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Code lookupK60.1

Effective periodFY2026 Apr Update (Apr 1-Sep 30)

FY 2026 Apr update / Diseases of the digestive system (K00-K95) / Other diseases of intestines (K55-K64)

K60.1

Billable / SpecificICD-10-CMOfficial ICD-10-CMCodebook guidance

Chronic anal fissure

A persistent tear in the anal canal lining that has lasted more than 6 weeks, causing ongoing pain and bleeding with bowel movements.

Overview Risk Models Code Book Documentation Audit Notes Edition comparison

CMS-HCC V28

N/A

—

Not risk-adjusted for this model/period.

Not mapped

CMS-HCC V24

Historical

Not used for standard CY2026 Medicare Advantage payment. Select a historical period to review V24.

Not used for CY2026 payment

ACA/HHS

N/A

—

Not risk-adjusted for this model/period.

Not mapped

ESRD/PACE

N/A

—

Not risk-adjusted for this model/period.

Not mapped

RXHCC

N/A

—

Not risk-adjusted for this model/period.

Not mapped

Code Book Path

Official

K60Fissure and fistula of anal and rectal regions K60.1Chronic anal fissure

Inclusion Terms

Official

No inclusion terms are included in this display for K60.1. Check the code and parent instructions in the Code Book.

Excludes 2

Official

certain conditions originating in the perinatal period (P04-P96)Inherited from K00-K95, K60
certain infectious and parasitic diseases (A00-B99)Inherited from K00-K95, K60
complications of pregnancy, childbirth and the puerperium (O00-O9A)Inherited from K00-K95, K60
congenital malformations, deformations and chromosomal abnormalities (Q00-Q99)Inherited from K00-K95, K60
endocrine, nutritional and metabolic diseases (E00-E88)Inherited from K00-K95, K60
injury, poisoning and certain other consequences of external causes (S00-T88)Inherited from K00-K95, K60
neoplasms (C00-D49)Inherited from K00-K95, K60
symptoms, signs and abnormal clinical and laboratory findings, not elsewhere classified (R00-R94)Inherited from K00-K95, K60
abscess or cellulitis of anal and rectal regions (K61.-)Inherited from K00-K95, K60
anal sphincter tear (healed) (nontraumatic) (old) (K62.81)Inherited from K00-K95, K60

Related Codes

Official

K60.0Acute anal fissure K60.2Anal fissure, unspecified K60.3Anal fistula K60.4Rectal fistula K60.5Anorectal fistula

Includes

Official

No Includes notes are included in this display for K60.1. Check the code and parent instructions in the Code Book.

Excludes 1

Official

No Excludes 1 notes are included in this display for K60.1. Check the code and parent instructions in the Code Book.

Code First

Official

No Code First sequencing instructions are included in this display for K60.1. Check the code and parent instructions in the Code Book.

Use Additional

Official

No Use Additional Code instructions are included in this display for K60.1. Check the code and parent instructions in the Code Book.

Code Also

Official

No Code Also instructions are included in this display for K60.1. Check the code and parent instructions in the Code Book.

Buddy Documentation Tip

HCC Buddy guidance

Ensure documentation specifies the chronic duration (typically >6 weeks) to differentiate from acute fissure

Document any associated complications or failed conservative treatments to support treatment decisions

Current with CMS: FY2026 ICD-10-CM Apr 1 update (effective Apr 1 – Sep 30, 2026) · CMS-HCC V28, 100% phased in for payment year 2026. FY2027 code set already staged for October 1, 2026. How HCC Buddy stays current →

Is K60.1 an HCC code?

No. K60.1 is a billable ICD-10-CM code with no mapping under the current CMS-HCC V28 community payment model, and none under the ESRD, Part D RxHCC, or HHS-HCC models.

Code: K60.1
Description: Chronic anal fissure
HCC (V28): No CMS-HCC V28 mapping
RAF reference coefficient: —
Billable: Yes
Payment year: 2026

Coder workflow notes

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What This Code Means

K60.1 is the ICD-10-CM diagnosis code for chronic anal fissure. A persistent tear in the anal canal lining that has lasted more than 6 weeks, causing ongoing pain and bleeding with bowel movements. K60.1 sits in the ICD-10-CM chapter for diseases of the digestive system (k00-k95), within the section covering other diseases of intestines (k55-k64).

K60.1 is a billable ICD-10-CM code, but no current CMS-HCC V28 community payment mapping is shown, and none under the ESRD, Part D RxHCC, or HHS-HCC models. Do not assign risk adjustment value from this page when no source-backed mapping is shown; verify the applicable model and payment year.

Ensure documentation specifies the chronic duration (typically >6 weeks) to differentiate from acute fissure.

HCC Buddy maintains structured V28 and V24 mapping, source-labeled coefficient references, and MEAT documentation criteria for K60.1 sourced directly from the CMS-HCC risk adjustment model files and the CMS ICD-10-CM code set.

Coding Tips

•Ensure documentation specifies the chronic duration (typically >6 weeks) to differentiate from acute fissure
•Document any associated complications or failed conservative treatments to support treatment decisions