2020 ICD-10-CM Diagnosis Code Q42.0

Congenital absence, atresia and stenosis of rectum with fistula

    2016 2017 2018 2019 2020 Billable/Specific Code POA Exempt
  • Q42.0 is a billable/specific ICD-10-CM code that can be used to indicate a diagnosis for reimbursement purposes.
  • Short description: Congenital absence, atresia and stenosis of rectum w fistula
  • The 2020 edition of ICD-10-CM Q42.0 became effective on October 1, 2019.
  • This is the American ICD-10-CM version of Q42.0 - other international versions of ICD-10 Q42.0 may differ.
The following code(s) above Q42.0 contain annotation back-references
Annotation Back-References
In this context, annotation back-references refer to codes that contain:
  • Applicable To annotations, or
  • Code Also annotations, or
  • Code First annotations, or
  • Excludes1 annotations, or
  • Excludes2 annotations, or
  • Includes annotations, or
  • Note annotations, or
  • Use Additional annotations
that may be applicable to Q42.0:
  • Q00-Q99
    2020 ICD-10-CM Range Q00-Q99

    Congenital malformations, deformations and chromosomal abnormalities

    Note
    • Codes from this chapter are not for use on maternal records
    Type 2 Excludes
    • inborn errors of metabolism (E70-E88)
    Congenital malformations, deformations and chromosomal abnormalities
  • Q42
    ICD-10-CM Diagnosis Code Q42

    Congenital absence, atresia and stenosis of large intestine

      2016 2017 2018 2019 2020 Non-Billable/Non-Specific Code
    Includes
    • congenital obstruction, occlusion and stricture of large intestine
    Congenital absence, atresia and stenosis of large intestine
Approximate Synonyms
  • Atresia of rectum with fistula
  • Congenital absence of rectum with fistula
  • Congenital rectal absence with fistula
  • Congenital rectal atresia with fistula
  • Congenital rectal stenosis with fistula
Present On Admission
POA Help
"Present On Admission" is defined as present at the time the order for inpatient admission occurs — conditions that develop during an outpatient encounter, including emergency department, observation, or outpatient surgery, are considered POA.
  • Q42.0 is considered exempt from POA reporting.
ICD-10-CM Q42.0 is grouped within Diagnostic Related Group(s) (MS-DRG v37.0):
  • 393 Other digestive system diagnoses with mcc
  • 394 Other digestive system diagnoses with cc
  • 395 Other digestive system diagnoses without cc/mcc

Convert Q42.0 to ICD-9-CM

Code History
  • 2016 (effective 10/1/2015): New code (first year of non-draft ICD-10-CM)
  • 2017 (effective 10/1/2016): No change
  • 2018 (effective 10/1/2017): No change
  • 2019 (effective 10/1/2018): No change
  • 2020 (effective 10/1/2019): No change
Code annotations containing back-references to Q42.0:
  • Type 1 Excludes: Q43.6
    ICD-10-CM Diagnosis Code Q43.6

    Congenital fistula of rectum and anus

      2016 2017 2018 2019 2020 Billable/Specific Code POA Exempt
    Type 1 Excludes
    • 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.-)

Diagnosis Index entries containing back-references to Q42.0:
  • Absence (of) (organ or part) (complete or partial)
    • rectum (congenital) Q42.1
      ICD-10-CM Diagnosis Code Q42.1

      Congenital absence, atresia and stenosis of rectum without fistula

        2016 2017 2018 2019 2020 Billable/Specific Code POA Exempt
      Applicable To
      • Imperforate rectum
      • with fistula Q42.0
  • Agenesis
    • rectum Q42.1
      ICD-10-CM Diagnosis Code Q42.1

      Congenital absence, atresia and stenosis of rectum without fistula

        2016 2017 2018 2019 2020 Billable/Specific Code POA Exempt
      Applicable To
      • Imperforate rectum
      • with fistula Q42.0
  • Atresia, atretic
    • rectum Q42.1
      ICD-10-CM Diagnosis Code Q42.1

      Congenital absence, atresia and stenosis of rectum without fistula

        2016 2017 2018 2019 2020 Billable/Specific Code POA Exempt
      Applicable To
      • Imperforate rectum
      • with fistula Q42.0
  • Fistula (cutaneous) L98.8
    ICD-10-CM Diagnosis Code L98.8

    Other specified disorders of the skin and subcutaneous tissue

      2016 2017 2018 2019 2020 Billable/Specific Code
    • rectum (to skin) K60.4
      ICD-10-CM Diagnosis Code K60.4

      Rectal fistula

        2016 2017 2018 2019 2020 Billable/Specific Code
      Applicable To
      • Fistula of rectum to skin
      Type 1 Excludes
      • rectovaginal fistula (N82.3)
      • vesicorectal fistual (N32.1)
      • congenital Q43.6
        ICD-10-CM Diagnosis Code Q43.6

        Congenital fistula of rectum and anus

          2016 2017 2018 2019 2020 Billable/Specific Code POA Exempt
        Type 1 Excludes
        • 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.-)
        • with absence, atresia and stenosis Q42.0
  • Hypoplasia, hypoplastic
    • rectum Q42.1
      ICD-10-CM Diagnosis Code Q42.1

      Congenital absence, atresia and stenosis of rectum without fistula

        2016 2017 2018 2019 2020 Billable/Specific Code POA Exempt
      Applicable To
      • Imperforate rectum
      • with fistula Q42.0
  • Imperforate (congenital) - see also Atresia
    • rectum Q42.1
      ICD-10-CM Diagnosis Code Q42.1

      Congenital absence, atresia and stenosis of rectum without fistula

        2016 2017 2018 2019 2020 Billable/Specific Code POA Exempt
      Applicable To
      • Imperforate rectum
      • with fistula Q42.0
  • Impervious (congenital) - see also Atresia
    • rectum Q42.1
      ICD-10-CM Diagnosis Code Q42.1

      Congenital absence, atresia and stenosis of rectum without fistula

        2016 2017 2018 2019 2020 Billable/Specific Code POA Exempt
      Applicable To
      • Imperforate rectum
      • with fistula Q42.0
  • Stricture - see also Stenosis
    • rectum (sphincter) K62.4
      ICD-10-CM Diagnosis Code K62.4

      Stenosis of anus and rectum

        2016 2017 2018 2019 2020 Billable/Specific Code
      Applicable To
      • Stricture of anus (sphincter)
      • congenital Q42.1
        ICD-10-CM Diagnosis Code Q42.1

        Congenital absence, atresia and stenosis of rectum without fistula

          2016 2017 2018 2019 2020 Billable/Specific Code POA Exempt
        Applicable To
        • Imperforate rectum
        • with fistula Q42.0

ICD-10-CM Codes Adjacent To Q42.0
Q40.3 Congenital malformation of stomach, unspecified
Q40.8 Other specified congenital malformations of upper alimentary tract
Q40.9 Congenital malformation of upper alimentary tract, unspecified
Q41 Congenital absence, atresia and stenosis of small intestine
Q41.0 Congenital absence, atresia and stenosis of duodenum
Q41.1 Congenital absence, atresia and stenosis of jejunum
Q41.2 Congenital absence, atresia and stenosis of ileum
Q41.8 Congenital absence, atresia and stenosis of other specified parts of small intestine
Q41.9 Congenital absence, atresia and stenosis of small intestine, part unspecified
Q42 Congenital absence, atresia and stenosis of large intestine
Q42.0 Congenital absence, atresia and stenosis of rectum with fistula
Q42.1 Congenital absence, atresia and stenosis of rectum without fistula
Q42.2 Congenital absence, atresia and stenosis of anus with fistula
Q42.3 Congenital absence, atresia and stenosis of anus without fistula
Q42.8 Congenital absence, atresia and stenosis of other parts of large intestine
Q42.9 Congenital absence, atresia and stenosis of large intestine, part unspecified
Q43 Other congenital malformations of intestine
Q43.0 Meckel's diverticulum (displaced) (hypertrophic)
Q43.1 Hirschsprung's disease
Q43.2 Other congenital functional disorders of colon
Q43.3 Congenital malformations of intestinal fixation

Reimbursement claims with a date of service on or after October 1, 2015 require the use of ICD-10-CM codes.