Anorectal fistula, complex, recurrent

This code signifies a re-presentation of an anorectal fistula that has previously been treated or spontaneously resolved, and is characterized by multiple tracts, involvement of significant portions of the external or internal anal sphincter, or association with other pelvic organs. It indicates a more intricate and challenging fistula compared to simple or uncomplicated types.

Apply this code when documentation clearly indicates a history of a previously treated or recurrent anorectal fistula that now presents with complex features. Supporting documentation should detail the complexity (e.g., high transsphincteric, suprasphincteric, extrasphincteric, multiple tracts) and evidence of prior treatment or recurrence.

• Differentiate from initial complex fistulas (K60.3) and simple recurrent fistulas (K60.42).
• Ensure the medical record explicitly states "recurrent" and details the "complex" nature of the fistula.
• Consider sequencing with codes for underlying conditions, such as Crohn's disease (K50.-), if applicable.