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

ICD-10 K60.521

Billable / Specific

Anorectal fistula, complex, initial

K60
Block
1
Synonyms
239
LCDs
8
Payer Policies
0
Linked CPTs

About ICD-10-CM K60.521

ICD-10-CM code K60.521 represents Anorectal fistula, complex, initial. This is a billable/specific code in the Digestive System chapter (block K60). The 2026 edition of ICD-10-CM K60.521 became effective on October 1, 2025.

Inclusion Terms / Approximate Synonyms

Clinical terms and conditions classified under K60.521. Per CMS ICD-10-CM Tabular 2026.

  • Anorectal fistula, complex, new

Medicare LCD Coverage for K60.521

Local Coverage Determinations (LCDs) from CMS MACs that list K60.521 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 K60.521.

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 K60.521

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

No procedure linkages on file for K60.521

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.

ICD-10 K60.521, Billing FAQ

Is ICD-10 code K60.521 billable? +

Yes, K60.521 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 K60.521? +

ICD-10 K60.521 includes: Anorectal fistula, complex, new.

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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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