Non-Billable / Non-Specific Code
ICD-10-CM K60.42 is the diagnosis code for Rectal fistula, complex. This code falls under the section "Other diseases of intestines" within Chapter 11 — Diseases of the digestive system (K00-K95). It is a non-billable/non-specific ICD-10-CM code that should not be used for reimbursement. A more specific sub-code is required for billing. Medical coders and healthcare providers use this code to document and classify diagnoses in electronic health records, insurance claims, and clinical databases.
Understanding where K60.42 sits in the ICD-10-CM classification helps ensure proper coding:
No, K60.42 is a non-billable/non-specific code. You should use a more specific sub-code for billing and reimbursement.
K60.42 is the ICD-10-CM diagnosis code for "Rectal fistula, complex". It is used by healthcare providers to classify and document this condition in medical records and insurance claims.
The parent code of K60.42 is K60.4 ("Rectal fistula"). K60.42 provides a more specific classification within this category.
K60.42 is located in Section K55-K64 — "Other diseases of intestines" within Chapter 11 of the ICD-10-CM Tabular List.
K60.42 has 4 sub-code(s) that provide more specific detail: K60.421, K60.422, K60.423, K60.429.
Use K60.42 when the patients documented diagnosis matches "Rectal fistula, complex" and the clinical documentation supports this level of specificity. Always verify with the latest ICD-10-CM guidelines and payer requirements.
The ICD-10-CM code for Rectal fistula, complex is K60.42.
No, K60.42 is non-billable. Use a more specific sub-code for primary diagnosis billing.
K60.42 is in Chapter 11 of the ICD-10-CM Tabular List.
Yes, K60.42 is a valid ICD-10-CM code for the 2026 fiscal year, subject to official CMS updates.