Q43.6

Q43.6

Billable

Congenital fistula of rectum and anus

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

What This Code Means

A birth defect where an abnormal tunnel or opening connects the rectum or anus to the skin or other structures, allowing drainage or infection.

Coding Tips

•Specify whether the fistula is rectoperineal, rectourethral, rectovaginal, or other type if documented
•This often requires surgical repair and may be associated with other anorectal malformations

Excludes 1 — Do NOT code together

congenital fistula of anus with absence, atresia and stenosis (Q42.2)
congenital fistula of rectum with absence, atresia and stenosis (Q42.0)
congenital rectovaginal fistula (Q52.2)
congenital urethrorectal fistula (Q64.73)
pilonidal fistula or sinus (L05.-)

Code Hierarchy

└Q43Other congenital malformations of intestine └Q43.6Congenital fistula of rectum and anus

└Q43.6Congenital fistula of rectum and anus