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K60.511

Billable

Anorectal fistula, simple, initial

This code does not map to an HCC category in any model (V28, V24, ESRD, RxHCC).

What This Code Means

An abnormal tunnel or opening between the anus and surrounding skin that is uncomplicated and occurring for the first time.

Coding Tips

  • Use this code only when the fistula is documented as simple (not complex) and the patient is experiencing it initially
  • Distinguish from persistent (512) and recurrent (513) codes based on clinical history and documentation

Code Hierarchy

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