Fistula ICD-10-CM Codes

Discover how ICD-10 Codes Used for Fistula can classify and manage fistula-related medical conditions. Explore accurate coding for effective healthcare.

By Karina Jimenea on Jun 16, 2024.

Fact Checked by Ericka Pingol.

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Fistula ICD-10-CM Codes

What ICD-10 Codes are Used for Fistula 

K60.3

K60.3 is an anal fistula ICD 10 code, which is an abnormal passage between the anal canal and the skin near the anus. This condition is frequently a result of infection or inflammation of the anal glands. Common symptoms of an anal fistula include pain, discharge, and bleeding. Typically, the treatment for an anal fistula involves surgical removal of the fistula tract.

K63.2 

As one of the Fistula ICD Codes, it denotes a fistula of the intestine, characterized by an abnormal passage between two parts of the intestine. This can be triggered by infection, inflammation, or trauma. Symptoms of an intestinal fistula encompass diarrhea, constipation, abdominal pain, and weight loss. The usual course of treatment for an intestinal fistula involves surgical removal of the fistula tract.

M25.18 

This code is used for fistulas occurring in various body parts, such as the bladder, lungs, or liver. The specific location of the fistula is indicated within the code. Symptoms of a fistula in other body parts can vary based on location. Typically, treatment for such fistulas necessitates surgery to remove the fistula tract.

J86.0 

The code is employed for cases of pyothorax with a fistula, where pus accumulates in the pleural space and is associated with a fistula. The fistula can be situated in the lung, chest wall, or other chest structures. Symptoms of pyothorax with fistula encompass chest pain, shortness of breath, and fever. Treatment generally involves surgical removal of the fistula and pus drainage.

T81.83XA

In the case of this code, it represents a persistent postprocedural fistula that develops following a medical procedure like surgery or childbirth. The fistula can occur in any body part, and symptoms can vary accordingly. Treatment for a persistent postprocedural fistula typically entails surgical removal of the fistula tract.

L03.3

This code indicates a tracheoesophageal fistula, an abnormal passage between the trachea (windpipe) and the esophagus (food pipe). Often present at birth, this condition can lead to breathing and eating difficulties. Symptoms of a tracheoesophageal fistula include coughing, choking, and difficulty breathing. Treatment typically involves surgical closure of the fistula.

I83.0

It is a code for an arteriovenous fistula, an abnormal connection between an artery and a vein. It can occur naturally or result from surgery or injury and can be located anywhere in the body. Symptoms depend on the specific location of the fistula. Treatment usually involves surgical closure.

Q39.0 

This code represents a congenital fistula of the heart, a birth defect involving an abnormal connection between two heart chambers. This condition can disrupt blood flow and oxygen delivery to the body, with symptoms varying based on the type of fistula. The standard treatment involves surgical closure.

Y83.51

It is used for fistulas that develop as complications of medical care, such as surgery or chemotherapy. These fistulas can occur in any body part, and symptoms depend on the location. Treatment typically involves surgical removal of the fistula tract.

Which Fistula ICD codes are Billable: 

  • K60.3: Yes
  • K63.2: Yes
  • M25.18: Yes
  • J86.0: Yes
  • T81.83XA: Yes
  • L03.3: No
  • I83.0: No
  • Q39.0: Yes
  • Y83.51: Yes

Clinical Information

  • Fistulas are abnormal connections between body parts, often caused by infection, inflammation, injury, or surgery.
  • Symptoms of fistulas include pain, discharge, bleeding, pus, swelling, inflammation, obstruction, and incontinence, varying by location and severity.
  • Common types of fistulas include anal fistulas (linked to anal gland infections), intestinal fistulas (resulting from infection, inflammation, or trauma), bladder fistulas (connecting the bladder to another organ), vaginal fistulas (associated with childbirth, infection, or surgery), tracheoesophageal fistulas (present at birth, affecting breathing and feeding), and arteriovenous fistulas (natural or surgery-related connections between arteries and veins).
  • Diagnosis involves comprehensive medical evaluations, imaging studies, endoscopic procedures, and diagnostic tests to identify the fistula's location and characteristics.
  • Treatment often includes surgical intervention to close the abnormal connection and repair associated damage.
  • Antibiotics may be prescribed if infections are involved.
  • Fistulas can occur in any part of the body but are most commonly found in the digestive tract, urinary tract, and female reproductive tract.
  • Early diagnosis and increased awareness are crucial for managing fistulas effectively and improving patient outcomes.

Synonyms Include:

  • Abnormal passage
  • Communication
  • Connection
  • Duct
  • Ganglion
  • Opening
  • Sinus
  • Tunnel
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Commonly asked questions

When to use a Fistula ICD code?

Applying a Fistula ICD code is appropriate when recording a patient's medical condition involving an abnormal connection between body parts or organs, such as an anal fistula or intestinal fistula. These codes are crucial in maintaining accurate medical records, facilitating insurance billing, and enabling effective communication among healthcare providers.

What are the common treatments for Fistula Diagnosis Codes?

Diagnosis Codes associated with Fistulas typically correspond to common treatment approaches that often involve surgical interventions to repair or close the abnormal connection. The specific treatment method employed is determined by factors such as the type, location, and severity of the fistula. Additionally, healthcare providers may prescribe antibiotics when infections are a contributing factor.

What does a diagnosis code for Fistula mean?

A diagnosis code for Fistula holds significance as it provides a standardized method for describing a patient's medical condition characterized by an abnormal connection between organs or body parts. These codes are universally recognized tools that facilitate precise communication, aiding in treatment planning, streamlining insurance claims processing, and supporting medical research efforts.

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