L05 vs Q43.6
L05 (Pilonidal cyst and sinus) compared with Q43.6 (Congenital fistula of rectum and anus), 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. Q43.6 carries an Excludes1 note covering L05: “pilonidal fistula or sinus (L05.-)”
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
| L05Pilonidal cyst and sinus | Q43.6Congenital fistula of rectum and anus | |
|---|---|---|
| Billing status | Non-billable header | Billable |
| Classification | L00-L99 — Diseases of the Skin and Subcutaneous Tissue (L00-L99) | Q00-Q99 — Congenital Malformations, Deformations and Chromosomal Abnormalities (Q00-Q99) |
| Definition | Pilonidal cyst and sinus is a non-billable ICD-10-CM category code (L05). | Congenital fistula of rectum and anus is a billable ICD-10-CM diagnosis code (Q43.6). |
| Use additional code | code (B95-B97) to identify infectious agent. | — |
Derived from the official CMS ICD-10-CM tabular data (FY2026). Not billing advice; verify sequencing rules for the encounter. All data sources