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M25.169

Billable

Fistula, unspecified knee

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 in the knee joint that allows fluid or infection to drain to the skin surface.

Coding Tips

  • •Verify if the fistula is related to infection, trauma, or surgery before coding
  • •Confirm laterality is truly unspecified; if right or left knee is documented, use M25.161 or M25.162 instead

Code Hierarchy

└M25Other joint disorder, not elsewhere classified└M25.1Fistula of joint└M25.16Fistula, knee└M25.169Fistula, unspecified knee
└M25.169Fistula, unspecified knee

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