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ICD-10-CM Codes
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Q00-Q99
Congenital malformations, deformations and chromosomal abnormalities
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Q38-Q45
Other congenital malformations of the digestive system
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Q43-
Other congenital malformations of intestine
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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 ExcludesType 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
- 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
- congenital rectovaginal fistula (
ICD-10-CM Diagnosis Code Q52.2
Congenital rectovaginal fistula
2016 2017 2018 2019 Billable/Specific Code Female Dx POA Exempt
- congenital urethrorectal fistula (
ICD-10-CM Diagnosis Code Q64.73
Congenital urethrorectal fistula
2016 2017 2018 2019 Billable/Specific Code POA Exempt
- 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
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:
- Congenital anal fistula
- Congenital fistula of rectum
- Congenital rectal fistula
Present On AdmissionPOA 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
- 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- fistula of duodenum (K31.6)
- fistula of intestine with Crohn's disease (K50.013, K50.113, K50.813, K50.913,)
- fistula of intestine with ulcerative colitis (K51.013, K51.213, K51.313, K51.413, K51.513, K51.813, K51.913)
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)
- 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
Q43.6
Congenital fistula of rectum and anus
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
Q44.5 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.
