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ICD-10-CM 2026 · Effective October 1, 2025

ICD-10 K60.323

Billable / Specific

Anal fistula, complex, recurrent

K60
Block
1
Synonyms
239
LCDs
8
Payer Policies
2
Linked CPTs

About ICD-10-CM K60.323

ICD-10-CM code K60.323 represents Anal fistula, complex, recurrent. This is a billable/specific code in the Digestive System chapter (block K60). The 2026 edition of ICD-10-CM K60.323 became effective on October 1, 2025.

Inclusion Terms / Approximate Synonyms

Clinical terms and conditions classified under K60.323. Per CMS ICD-10-CM Tabular 2026.

  • Anal fistula complex, occurring following complete healing

Medicare LCD Coverage for K60.323

Local Coverage Determinations (LCDs) from CMS MACs that list K60.323 as a covered diagnosis.

239 LCDs

Showing top 10 of 239 total . Click a CPT for full coverage scope.

CMS LCD: Billing and Coding: Transrectal Ultrasound
Article ID: 57427, Effective: 2024-10-01 00:00:00, 118 covered, 0 non-covered
CPT 76872 →
CMS LCD: Billing and Coding: Transrectal Ultrasound
Article ID: 57427, Effective: 2024-10-01 00:00:00, 118 covered, 0 non-covered
CPT 76873 →
CMS LCD: Billing and Coding: Botulinum Toxin Injections
Article ID: 57186, Effective: 2026-04-09 00:00:00, 341 covered, 0 non-covered
CPT 64646 →
CMS LCD: Billing and Coding: Botulinum Toxin Injections
Article ID: 57186, Effective: 2026-04-09 00:00:00, 341 covered, 0 non-covered
CPT 52287 →
CMS LCD: Billing and Coding: Botulinum Toxin Injections
Article ID: 57186, Effective: 2026-04-09 00:00:00, 341 covered, 0 non-covered
CPT J0589 →
CMS LCD: Billing and Coding: Botulinum Toxin Injections
Article ID: 57186, Effective: 2026-04-09 00:00:00, 341 covered, 0 non-covered
CPT 64616 →
CMS LCD: Billing and Coding: Botulinum Toxin Injections
Article ID: 57186, Effective: 2026-04-09 00:00:00, 341 covered, 0 non-covered
CPT 43236 →
CMS LCD: Billing and Coding: Botulinum Toxin Injections
Article ID: 57186, Effective: 2026-04-09 00:00:00, 341 covered, 0 non-covered
CPT 64611 →
CMS LCD: Billing and Coding: Botulinum Toxin Injections
Article ID: 57186, Effective: 2026-04-09 00:00:00, 341 covered, 0 non-covered
CPT 64650 →
CMS LCD: Billing and Coding: Botulinum Toxin Injections
Article ID: 57186, Effective: 2026-04-09 00:00:00, 341 covered, 0 non-covered
CPT 31570 →

Commercial Payer Coverage

Coverage policies from major commercial payers referencing K60.323.

8 policies

5 Medicare

Billing and Coding: Colonoscopy/Sigmoidoscopy/Proctosigmoidoscopy
Policy ID: ART-56632
Billing and Coding: Botulinum Toxin Injections
Policy ID: ART-57185
Billing and Coding: Botulinum Toxin Injections
Policy ID: ART-57186
Billing and Coding: Transrectal Ultrasound
Policy ID: ART-57427
Billing and Coding: Botulinum Toxin Injections
Policy ID: ART-59707

CPT Codes Commonly Billed with K60.323

Procedures frequently paired with this diagnosis based on PayerReady's Dx↔Px linkage data.

2 linkages
  • 76873 CMS LCD: Billing and Coding: Transrectal Ultrasound CMS LCD
  • 76872 CMS LCD: Billing and Coding: Transrectal Ultrasound CMS LCD

Codes Adjacent To K60.323

Other codes in section K55-K64 (Other diseases of intestines).

K55 Vascular disorders of intestine (non-billable) K55.0 Acute vascular disorders of intestine (non-billable) K55.01 Acute (reversible) ischemia of small intestine (non-billable) K55.011 Focal (segmental) acute (reversible) ischemia of small intestine K55.012 Diffuse acute (reversible) ischemia of small intestine K55.019 Acute (reversible) ischemia of small intestine, extent unspecified K55.02 Acute infarction of small intestine (non-billable) K55.021 Focal (segmental) acute infarction of small intestine K55.022 Diffuse acute infarction of small intestine K55.029 Acute infarction of small intestine, extent unspecified K55.03 Acute (reversible) ischemia of large intestine (non-billable) K55.031 Focal (segmental) acute (reversible) ischemia of large intestine K55.032 Diffuse acute (reversible) ischemia of large intestine K55.039 Acute (reversible) ischemia of large intestine, extent unspecified K55.04 Acute infarction of large intestine (non-billable) K55.041 Focal (segmental) acute infarction of large intestine K55.042 Diffuse acute infarction of large intestine K55.049 Acute infarction of large intestine, extent unspecified K55.05 Acute (reversible) ischemia of intestine, part unspecified (non-billable) K55.051 Focal (segmental) acute (reversible) ischemia of intestine, part unspecified

ICD-10 K60.323, Billing FAQ

Is ICD-10 code K60.323 billable? +

Yes, K60.323 is a billable ICD-10-CM code that can appear as a primary or secondary diagnosis on claims.

What other names or terms map to K60.323? +

ICD-10 K60.323 includes: Anal fistula complex, occurring following complete healing.

What CPT codes are commonly billed with K60.323? +

Procedures frequently paired with K60.323 include: 76873, 76872.

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Reviewed by the PayerReady Medical Coding Team

Verified against the CMS 2026 code set on July 16, 2026.

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