2019 ICD-10-CM Diagnosis Code Q43.6

Congenital fistula of rectum and anus

    2016 2017 2018 2019 Billable/Specific Code POA Exempt
  • Q43.6 is a billable/specific ICD-10-CM code that can be used to indicate a diagnosis for reimbursement purposes.
  • The 2019 edition of ICD-10-CM Q43.6 became effective on October 1, 2018.
  • This is the American ICD-10-CM version of Q43.6 - other international versions of ICD-10 Q43.6 may differ.
Type 1 Excludes
Type 1 Excludes Help
A type 1 excludes note is a pure excludes. It means "not coded here". A type 1 excludes note indicates that the code excluded should never be used at the same time as Q43.6. A type 1 excludes note is for used for when two conditions cannot occur together, such as a congenital form versus an acquired form of the same condition.
  • congenital fistula of anus with absence, atresia and stenosis (
    ICD-10-CM Diagnosis Code Q42.2

    Congenital absence, atresia and stenosis of anus with fistula

      2016 2017 2018 2019 Billable/Specific Code POA Exempt
    Q42.2
    )
  • congenital fistula of rectum with absence, atresia and stenosis (
    ICD-10-CM Diagnosis Code Q42.0

    Congenital absence, atresia and stenosis of rectum with fistula

      2016 2017 2018 2019 Billable/Specific Code POA Exempt
    Q42.0
    )
  • congenital rectovaginal fistula (
    ICD-10-CM Diagnosis Code Q52.2

    Congenital rectovaginal fistula

      2016 2017 2018 2019 Billable/Specific Code Female Dx POA Exempt
    Type 1 Excludes
    Q52.2
    )
  • congenital urethrorectal fistula (
    ICD-10-CM Diagnosis Code Q64.73

    Congenital urethrorectal fistula

      2016 2017 2018 2019 Billable/Specific Code POA Exempt
    Q64.73
    )
  • pilonidal fistula or sinus (
    ICD-10-CM Diagnosis Code L05
    • L05 Pilonidal cyst and sinus
      • L05.0 Pilonidal cyst and sinus with abscess
        • L05.01 Pilonidal cyst with abscess
        • L05.02 Pilonidal sinus with abscess
      • L05.9 Pilonidal cyst and sinus without abscess
        • L05.91 Pilonidal cyst without abscess
        • L05.92 Pilonidal sinus without abscess
    L05.-
    )
The following code(s) above Q43.6 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 Q43.6:
  • Q00-Q99
    2019 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
Approximate Synonyms
  • Congenital anal fistula
  • Congenital fistula of rectum
  • Congenital rectal 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.
  • Q43.6 is considered exempt from POA reporting.
ICD-10-CM Q43.6 is grouped within Diagnostic Related Group(s) (MS-DRG v36.0):
  • 393 Other digestive system diagnoses with mcc
  • 394 Other digestive system diagnoses with cc
  • 395 Other digestive system diagnoses without cc/mcc

Convert Q43.6 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

Diagnosis Index entries containing back-references to Q43.6:
  • Fistula (cutaneous) L98.8
    ICD-10-CM Diagnosis Code L98.8

    Other specified disorders of the skin and subcutaneous tissue

      2016 2017 2018 2019 Billable/Specific Code
    • anus, anal (recurrent) (infectional) K60.3
      ICD-10-CM Diagnosis Code K60.3

      Anal fistula

        2016 2017 2018 2019 Billable/Specific Code
    • fecal K63.2
      ICD-10-CM Diagnosis Code K63.2

      Fistula of intestine

        2016 2017 2018 2019 Billable/Specific Code
      Type 1 Excludes
      Type 2 Excludes
      • fistula of anal and rectal regions (K60.-)
      • fistula of appendix (K38.3)
      • intestinal-genital fistula, female (N82.2-N82.4)
      • vesicointestinal fistula (N32.1)
      • congenital Q43.6
    • rectum (to skin) K60.4
      ICD-10-CM Diagnosis Code K60.4

      Rectal fistula

        2016 2017 2018 2019 Billable/Specific Code
      Applicable To
      • Fistula of rectum to skin
      Type 1 Excludes
      • rectovaginal fistula (N82.3)
      • vesicorectal fistual (N32.1)

ICD-10-CM Codes Adjacent To Q43.6
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
Q43.4 Duplication of intestine
Q43.5 Ectopic anus
Q43.6 Congenital fistula of rectum and anus
Q43.7 Persistent cloaca
Q43.8 Other specified congenital malformations of intestine
Q43.9 Congenital malformation of intestine, unspecified
Q44 Congenital malformations of gallbladder, bile ducts and liver
Q44.0 Agenesis, aplasia and hypoplasia of gallbladder
Q44.1 Other congenital malformations of gallbladder
Q44.2 Atresia of bile ducts
Q44.3 Congenital stenosis and stricture of bile ducts
Q44.4 Choledochal cyst
Q44.5 Other congenital malformations of bile ducts

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