Chronic anal fissure

This code describes a persistent, non-healing tear or ulcer in the anoderm, typically located in the posterior midline. It is characterized by chronic inflammation, induration, and often an associated sentinel pile or hypertrophied anal papilla. The condition is usually painful, especially during and after defecation, and may be accompanied by bleeding.

Assign this code when documentation clearly indicates an anal fissure that has been present for an extended period, typically more than six weeks, or exhibits features of chronicity such as fibrosis or a sentinel tag. This code is appropriate for patients presenting with long-standing anal pain, bleeding, or a palpable fissure with hardened edges. Supporting documentation should specify the chronic nature of the fissure.

• Differentiate from acute anal fissure (K60.0), which lacks the prolonged duration and chronic features.
• Ensure documentation specifies "chronic" or indicates a duration consistent with chronicity (e.g., "present for 3 months").
• Consider co-occurring conditions like constipation (K59.00) or hemorrhoids (I84.-) if documented, as they can contribute to or result from anal fissures.