Congenital absence, atresia and stenosis of rectum w fistula

This diagnosis code signifies a birth defect characterized by the complete or partial absence, or abnormal narrowing, of the rectum, which is also accompanied by an abnormal connection (fistula) to another organ or to the skin. This condition prevents normal passage of stool and often requires surgical intervention.

Assign this code for congenital malformations where the rectum is either missing, underdeveloped, or abnormally constricted, and a fistula is explicitly documented. This typically applies to newborns or infants presenting with symptoms of intestinal obstruction and a visible or suspected abnormal communication. Documentation should clearly state "congenital absence," "atresia," or "stenosis" of the rectum, along with the presence of a "fistula."

• Ensure documentation specifies "rectum" and not just "anus" or "large intestine" for accurate coding.
• Distinguish from conditions without a fistula; a separate code exists for rectal atresia/stenosis without fistula.
• Always review operative reports and imaging studies for precise anatomical details and the presence/location of the fistula.