Rectal fistula, complex, recurrent

This code signifies a complex, recurring abnormal tract connecting the rectum to another organ or the skin surface. The "complex" nature implies multiple tracts, involvement of significant portions of the sphincter muscle, or a high fistula. "Recurrent" indicates a return of the fistula after previous treatment or spontaneous closure.

Apply this code when documentation clearly states a patient presents with a rectal fistula that is both complex in its anatomical presentation and has recurred following prior management. Supporting documentation should detail the complexity (e.g., high, multiple tracts, sphincter involvement) and the history of recurrence.

• Ensure documentation explicitly states both "complex" and "recurrent." If only one is present, a different code may be more appropriate.
• Distinguish from simple or non-recurrent rectal fistulas (K60.41x, K60.40).
• Consider sequencing with codes for underlying conditions that may contribute to fistula formation, such as Crohn's disease (K50.-).