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Compare/K60.4 vs N32.1

K60.4 vs N32.1

K60.4 (Rectal fistula) compared with N32.1 (Vesicointestinal fistula), from the official CMS tabular data. Do not report these codes together: the official tabular list marks them Excludes1.

Can these codes be reported together?

No — do not report together. K60.4 carries an Excludes1 note covering N32.1: “vesicorectal fistual (N32.1)”

Sole exception: when the two conditions are documented as unrelated to each other (ICD-10-CM Official Guidelines, Section I.A.12.a).

Side by side

K60.4Rectal fistulaN32.1Vesicointestinal fistula
Billing statusNon-billable header

Report instead: K60.40, K60.411, K60.412, K60.413, K60.419

Billable
ClassificationK00-K95 — Diseases of the Digestive System (K00-K95)N00-N99 — Diseases of the Genitourinary System (N00-N99)
DefinitionRectal fistula is a non-billable ICD-10-CM category code (K60.4).Vesicointestinal fistula is a billable ICD-10-CM diagnosis code (N32.1).
Includes
Fistula of rectum to skin
Vesicorectal fistula
Code first
, if applicable:
Crohn's disease (K50.-)

Derived from the official CMS ICD-10-CM tabular data (FY2026). Not billing advice; verify sequencing rules for the encounter. All data sources