Q42.3

Billable

Congenital absence, atresia and stenosis of anus without fistula

HCC Category Mapping

V28HCC 78 — Intestinal Obstruction/Perforation

0.000

What This Code Means

A birth defect where the anus is completely absent or abnormally closed without an abnormal opening, preventing normal bowel elimination.

Coding Tips

•Confirm the absence of a fistula to differentiate from Q42.2; this is critical for accurate coding.
•Document whether the condition is imperforate anus or anal stenosis, as this affects management.

Clinical Significance

Congenital anal atresia without fistula, also known as imperforate anus, represents a relatively simpler form of anorectal malformation but still requires surgical intervention and long-term management to achieve normal bowel function and continence.

Documentation Requirements

✓Confirmation of imperforate anus without fistula
✓Assessment of anal dimple and perineal anatomy
✓Associated anomalies screening (VACTERL sequence)
✓Surgical approach and anoplasty technique
✓Post-operative anal dilation protocols
✓Continence assessment and management
✓Growth and development monitoring
✓Long-term colorectal surgery follow-up

Commonly Confused Codes

Q42.0 — Congenital rectal atresia with fistula (rectal level with fistula)Q42.1 — Congenital rectal atresia without fistula (rectal vs anal level)Q42.2 — Congenital anal atresia with fistula (has fistula component)Q43.1 — Hirschsprung disease (functional vs anatomic abnormality)

Code Hierarchy

└Q42Congenital absence, atresia and stenosis of large intestine └Q42.3Congenital absence, atresia and stenosis of anus without fistula

└Q42.3Congenital absence, atresia and stenosis of anus without fistula