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

ICD-10 K62.81

Billable / Specific

Anal sphincter tear (healed) (nontraumatic) (old)

K62
Block
1
Synonyms
124
LCDs
3
Payer Policies
0
Linked CPTs

About ICD-10-CM K62.81

ICD-10-CM code K62.81 represents Anal sphincter tear (healed) (nontraumatic) (old). This is a billable/specific code in the Digestive System chapter (block K62). The 2026 edition of ICD-10-CM K62.81 became effective on October 1, 2025.

Inclusion Terms / Approximate Synonyms

Clinical terms and conditions classified under K62.81. Per CMS ICD-10-CM Tabular 2026.

  • Tear of anus, nontraumatic

Type 2 Excludes

Not included here, the excluded code is not part of K62.81, but a patient may have both conditions at the same time. Both codes may be coded together when applicable.

  • anal fissure (K60.-)
  • anal sphincter tear (healed) (old) complicating delivery (O34.7-)
  • traumatic tear of anal sphincter (S31.831)

Use Additional Code

When coding K62.81, also report these additional codes when applicable.

  • code for any associated fecal incontinence (R15.-)

Medicare LCD Coverage for K62.81

Local Coverage Determinations (LCDs) from CMS MACs that list K62.81 as a covered diagnosis.

124 LCDs

Showing top 10 of 124 total . Click a CPT for full coverage scope.

CMS LCD: Billing and Coding: Colonoscopy/Sigmoidoscopy/Proctosigmoidoscopy
Article ID: 56632, Effective: 2025-10-01 00:00:00, 558 covered, 0 non-covered
CPT 45341 →
CMS LCD: Billing and Coding: Colonoscopy/Sigmoidoscopy/Proctosigmoidoscopy
Article ID: 56632, Effective: 2025-10-01 00:00:00, 558 covered, 0 non-covered
CPT 45331 →
CMS LCD: Billing and Coding: Colonoscopy/Sigmoidoscopy/Proctosigmoidoscopy
Article ID: 56632, Effective: 2025-10-01 00:00:00, 558 covered, 0 non-covered
CPT 45398 →
CMS LCD: Billing and Coding: Colonoscopy/Sigmoidoscopy/Proctosigmoidoscopy
Article ID: 56632, Effective: 2025-10-01 00:00:00, 558 covered, 0 non-covered
CPT G9999 →
CMS LCD: Billing and Coding: Colonoscopy/Sigmoidoscopy/Proctosigmoidoscopy
Article ID: 56632, Effective: 2025-10-01 00:00:00, 558 covered, 0 non-covered
CPT 44392 →
CMS LCD: Billing and Coding: Colonoscopy/Sigmoidoscopy/Proctosigmoidoscopy
Article ID: 56632, Effective: 2025-10-01 00:00:00, 558 covered, 0 non-covered
CPT 45386 →
CMS LCD: Billing and Coding: Colonoscopy/Sigmoidoscopy/Proctosigmoidoscopy
Article ID: 56632, Effective: 2025-10-01 00:00:00, 558 covered, 0 non-covered
CPT 45378 →
CMS LCD: Billing and Coding: Colonoscopy/Sigmoidoscopy/Proctosigmoidoscopy
Article ID: 56632, Effective: 2025-10-01 00:00:00, 558 covered, 0 non-covered
CPT 45305 →
CMS LCD: Billing and Coding: Colonoscopy/Sigmoidoscopy/Proctosigmoidoscopy
Article ID: 56632, Effective: 2025-10-01 00:00:00, 558 covered, 0 non-covered
CPT 45309 →
CMS LCD: Billing and Coding: Colonoscopy/Sigmoidoscopy/Proctosigmoidoscopy
Article ID: 56632, Effective: 2025-10-01 00:00:00, 558 covered, 0 non-covered
CPT 44390 →

Commercial Payer Coverage

Coverage policies from major commercial payers referencing K62.81.

3 policies

3 Medicare

Billing and Coding: Colonoscopy/Sigmoidoscopy/Proctosigmoidoscopy
Policy ID: ART-56456
Billing and Coding: Colonoscopy/Sigmoidoscopy/Proctosigmoidoscopy
Policy ID: ART-56632
Billing and Coding: Diagnostic and Therapeutic Colonoscopy
Policy ID: ART-57342

CPT Codes Commonly Billed with K62.81

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

No procedure linkages on file for K62.81

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 K62.81 to ICD-9-CM

Per CMS General Equivalence Mappings (GEMs), useful for legacy data review and historical claim analysis.

ICD-10ICD-9Mapping Flags
K62.81 56943 00000

Flags format (5 digits): Approximate · No Map · Combination · Scenario · Choice List. Source: CMS 2017 GEMs (final version).

ICD-10 K62.81, Billing FAQ

Is ICD-10 code K62.81 billable? +

Yes, K62.81 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 K62.81? +

ICD-10 K62.81 includes: Tear of anus, nontraumatic.

What codes are Type 2 Excludes for K62.81? +

Type 2 Excludes (may be coded together when both conditions exist): anal fissure (K60.-); anal sphincter tear (healed) (old) complicating delivery (O34.7-); traumatic tear of anal sphincter (S31.831)

What ICD-9 codes does K62.81 map to? +

Per CMS GEMs, K62.81 maps to ICD-9 codes: 56943. 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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