ICD10BillableValid for clinical use

ICD-10 Code Q43.6: Congenital fistula of rectum and anus

Q43.6 is a billable ICD-10 diagnosis code used to classify Congenital fistula of rectum and anus in medical records and claims. You may see this code in hospital records, discharge summaries, insurance claims, encounter documentation, referrals, or other healthcare billing and coding records. ICD-10 codes are diagnosis classification codes used in healthcare records, reporting, coding workflows, and billing support. This code sits within the broader ICD-10 area for Congenital malformations, deformations, chromosomal abnormalities, and genetic disorders (Q00-QA0).

Reviewed by HealthAssure Clinical TeamUpdated 26 May 2026

What is this code?

ICD-10 codes are diagnosis classification codes used in healthcare records, reporting, coding workflows, and billing support. This code sits within the broader ICD-10 area for Congenital malformations, deformations, chromosomal abnormalities, and genetic disorders (Q00-QA0).

When is it used?

  • May be used when a clinician documents congenital fistula of rectum and anus in a patient's medical record.
  • May appear in hospital records, claims, referrals, and clinical documentation.
  • This code can be used as a clinically usable diagnosis entry in standardized coding workflows.

What it does not mean

  • A code alone does not explain severity, treatment plan, or outcome.
  • A medical code should not be treated as a substitute for a doctor's diagnosis or advice.

Code hierarchy

chapter
17Congenital malformations, deformations, chromosomal abnormalities, and genetic disorders (Q00-QA0)
block
Q38-Q45Other congenital malformations of the digestive system
category
Q43Other congenital malformations of intestine
currentQ43

Official coding notes

Excludes1 (do not code together)
  • congenital fistula of anus with absence, atresia and stenosis (Q42.2)
  • congenital fistula of rectum with absence, atresia and stenosis (Q42.0)
  • congenital rectovaginal fistula (Q52.2)
  • congenital urethrorectal fistula (Q64.73)
  • pilonidal fistula or sinus (L05.-)

Where you may see this code

You may see this code in hospital records, discharge summaries, insurance claims, encounter documentation, referrals, or other healthcare billing and coding records.

Coverage-related procedures and services

CPT 44388high
COLONOSCOPY THROUGH STOMA; DIAGNOSTIC, INCLUDING COLLECTION OF SPECIMEN(S) BY BRUSHING OR WASHING, WHEN PERFORMED (SEPARATE PROCEDURE)
Source: CMS coverage guidance
CPT 44401high
COLONOSCOPY THROUGH STOMA; WITH ABLATION OF TUMOR(S), POLYP(S), OR OTHER LESION(S) (INCLUDES PRE-AND POST-DILATION AND GUIDE WIRE PASSAGE, WHEN PERFORMED)
Source: CMS coverage guidance
CPT 44389high
COLONOSCOPY THROUGH STOMA; WITH BIOPSY, SINGLE OR MULTIPLE
Source: CMS coverage guidance
CPT 44391high
COLONOSCOPY THROUGH STOMA; WITH CONTROL OF BLEEDING, ANY METHOD
Source: CMS coverage guidance
CPT 44402high
COLONOSCOPY THROUGH STOMA; WITH ENDOSCOPIC STENT PLACEMENT (INCLUDING PRE- AND POST-DILATION AND GUIDE WIRE PASSAGE, WHEN PERFORMED)
Source: CMS coverage guidance
CPT 44390high
COLONOSCOPY THROUGH STOMA; WITH REMOVAL OF FOREIGN BODY(S)
Source: CMS coverage guidance

Coding guidelines

Compatibility

Legacy and official ICD code match exactly.
Legacy codes
Q43.6

Common synonyms

Congenital fistula of rectum and anus

Frequently asked questions

Code details

CodeQ43.6
SystemICD10
Display nameCongenital fistula of rectum and anus
ChapterCongenital malformations, deformations, chromosomal abnormalities, and genetic disorders (Q00-QA0)
BlockOther congenital malformations of the digestive system

Flags

BillableYes
Valid clinical useYes

Source

SourceICD-10
Version2026-annual
Releaseannual
Year2026

Index terms

Matched terms
Fistula(cutaneous)Fistula(cutaneous)Fistula(cutaneous)

About this content

This page is prepared by HealthAssure's clinical team using official coding standards from ICD-10. AI tools assist with drafting explanations, which are then reviewed and verified by healthcare professionals for accuracy. This content is for informational purposes and does not replace professional medical advice. Meet our team.

ICD-10 Code Q43.6 for Congenital fistula of rectum and anus | HealthAssure