ICD-10 K60.5
Non-Billable HeaderAnorectal fistula
About ICD-10-CM K60.5
ICD-10-CM code K60.5 represents Anorectal fistula. This is a non-billable header code in the Digestive System chapter (block K60). The 2026 edition of ICD-10-CM K60.5 became effective on October 1, 2025. Non-billable codes cannot be used as a primary or secondary diagnosis on a claim, use a more specific child code instead.
Type 1 Excludes
Pure excludes, these codes can never be coded together with K60.5. The conditions are mutually exclusive (e.g., congenital vs acquired forms).
- congenital fistula (Q43.6)
Coding Notes
Code First
- , if applicable:
- Crohn's disease (K50.-)
- ulcerative colitis (K51.-)
Medicare LCD Coverage for K60.5
Local Coverage Determinations (LCDs) from CMS MACs that list K60.5 as a covered diagnosis.
Showing top 10 of 124 total . Click a CPT for full coverage scope.
Commercial Payer Coverage
Coverage policies from major commercial payers referencing K60.5.
5 Medicare
CPT Codes Commonly Billed with K60.5
Procedures frequently paired with this diagnosis based on PayerReady's Dx↔Px linkage data.
We don't have CPT pairings indexed for this specific code yet. Use the CPT search above to find common procedures, or check your payer's published medical policy for code-specific guidance.
Convert K60.5 to ICD-9-CM
Per CMS General Equivalence Mappings (GEMs), useful for legacy data review and historical claim analysis.
| ICD-10 | ICD-9 | Mapping Flags |
|---|---|---|
| K60.5 | 5651 | 10000 |
Flags format (5 digits): Approximate · No Map · Combination · Scenario · Choice List. Source: CMS 2017 GEMs (final version).
Codes Adjacent To K60.5
Other codes in section K55-K64 (Other diseases of intestines).
ICD-10 K60.5, Billing FAQ
Is ICD-10 code K60.5 billable? +
No, K60.5 is a non-billable header code. Use a more specific child code from block K60 when submitting claims.
What codes are Type 1 Excludes for K60.5? +
Type 1 Excludes (never code together with K60.5): congenital fistula (Q43.6)
What ICD-9 codes does K60.5 map to? +
Per CMS GEMs, K60.5 maps to ICD-9 codes: 5651. Useful for legacy data review and historical claim analysis.
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Reviewed by the PayerReady Medical Coding Team
Verified against the CMS 2026 code set on May 31, 2026.
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