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K61.3 ICD-10-CM Code: Ischiorectal abscess

Compare with another code for K61.3Check this code on a claim

Billing Status: NO. This is a non-billable ICD-10-CM code: report a more specific billable code beneath it.

Coding at a Glance

Official instructions
2 inclusion terms

What these terms mean →

Not billable · FY2027A non-billable heading in the tabular list: report a more specific code beneath it.

What you need to know

Source: CMS/NCHS Official ICD-10-CM tabular notes, quoted. From the CMS/NCHS tabular list for the release in force. A note the category or block publishes applies to this code too, and is marked with where it comes from.

Includesfrom K61What K61 covers
  • abscess of anal and rectal regions
  • cellulitis of anal and rectal regions

Where it sits Source: CMS/NCHS

Under:Chapter 11: Diseases of the Digestive SystemK55-K64 Other diseases of intestinesK61 Abscess of anal and rectal regions

Codes under K61.3 (2)

  • K61.31Horseshoe abscessBillable
  • K61.39Other ischiorectal abscessBillable

CompareCheck ClaimView Related Codes

Coding instructions

Official Tabular Instructional Notes: the inclusion, exclusion and sequencing notes published for K61.3 in the official ICD-10-CM tabular list, quoted as published.

Source: CMS/CDC — ICD-10-CM Tabular ListRelease: FY2027Effective: October 1, 2026

Trace:FY2027 changesChange historyRelease, file and checksum

Notes without a marker are published on K61.3 itself; “inherited from” names the category or block whose note applies here.

Includes

Conditions the official ICD-10-CM tabular list includes under this code.

  • abscess of anal and rectal regions
  • cellulitis of anal and rectal regions

Source: inherited from K61

Coder workflow for K61.3

MedCoder structured workflow — derived from this code’s own official record

Before you code K61.3

  1. K61.3 is not reportable as written. Select the more specific code beneath it that the documentation supports. Codes are reported to the highest level of specificity the classification provides (Guidelines I.B.2).

    ReviewK61.31, K61.39

    See the relationships section · Guide: How to choose an ICD-10-CM code →

Choose the right path

  1. Does the documentation support one of the more specific codes beneath K61.3?
    Yes → Select that code and continue the checks below on its own page.
    No → K61.3 cannot be reported as written. Where the codes beneath it include an unspecified code, that code applies when the record goes no further; otherwise query for the missing detail.

    ReviewK61.31, K61.39

Report the code beneath K61.3 that the documentation supports, not K61.3 itself. Then confirm that code is valid for the date of service on its own page.

Documentation check

The provider’s diagnostic statement
Codes are assigned from the provider’s documented diagnosis, not from clinical criteria, test values or a medication list (Guidelines I.A.19).

Every row is derived from this code’s own record — its title, tabular notes, 7th-character family and same-category siblings — with fixed MedCoder wording; nothing is inferred about a patient. The official notes and guideline text are in the sections each row links to, and they control.

Coding context

Guidelines, coding notes, decision aids, relationships (with MS-DRG and CCSR classification), hierarchy, HCC, coverage and the context map: what a coder reaches for after the core. Each section names whether it is official source data, a MedCoder-derived relationship or MedCoder editorial.

Code Overview

Ischiorectal abscess is a non-billable ICD-10-CM category code (K61.3). A more specific billable subcode must be selected for claims submission.

MedCoder summary Summary composed by MedCoder from this code's official ICD-10-CM record. The tabular instructional notes themselves appear verbatim below.

Verify Before Coding

  • Not billable as written — a more specific code is required: K61.31, K61.39.

From the code registry, the Medicare Code Editor, and the MS-DRG Definitions Manual. Check it against a full claim in Claim Check.

Relationships & Classification

MedCoder-derived relationships — computed from published CMS and AHRQ datasets

Other codes that name K61.3 or its code family, from the CMS ICD-10-CM tabular instructional notes. Tabular-note edges are stored at the code family level that carries each note.

Referenced by 5 Excludes2 notes across 2 chapters: K60 — Fissure and fistula of anal and rectal regions (via K61.-), K63.0 — Abscess of intestine (via K61.-), L02 — Cutaneous abscess, furuncle and carbuncle (via K61.-), L03 — Cellulitis and acute lymphangitis (via K61.-), L03.31 — Cellulitis of trunk (via K61.-).

These codes’ tabular lists name this diagnosis as distinct — both may be reported when both are documented.

Clinical classification (AHRQ CCSR):DIG016 — Peritonitis and intra-abdominal abscess (default); DIG015 — Anal and rectal conditions.

Clinical Classifications Software Refined (CCSR) for ICD-10-CM Diagnoses. Healthcare Cost and Utilization Project (HCUP), Agency for Healthcare Research and Quality.

Related Codes

Same clinical category (CCSR)

AHRQ's Clinical Classifications Software groups these diagnoses under the same clinical categories (Peritonitis and intra-abdominal abscess, Anal and rectal conditions).

K60.512 — Anorectal fistula, simple, persistent, K60.513 — Anorectal fistula, simple, recurrent, K60.519 — Anorectal fistula, simple, unspecified, K60.521 — Anorectal fistula, complex, initial, K60.522 — Anorectal fistula, complex, persistent, K60.523 — Anorectal fistula, complex, recurrent, K60.529 — Anorectal fistula, complex, unspecified, K61.0 — Anal abscess, K61.1 — Rectal abscess, K61.2 — Anorectal abscess, K61.31 — Horseshoe abscess, K61.39 — Other ischiorectal abscess, K61.4 — Intrasphincteric abscess, K61.5 — Supralevator abscess, K62.0 — Anal polyp, K62.1 — Rectal polyp, K62.2 — Anal prolapse, K62.3 — Rectal prolapse, K62.4 — Stenosis of anus and rectum, K62.6 — Ulcer of anus and rectum, +83 more

Contextual Map

Every relationship of K61.3 in one view: hierarchy, official tabular instructions in both directions, clinical classification, risk adjustment, MS-DRG participation, index terms and change history — each edge carrying the CMS source it derives from.

Run K61.3 with these 5 related codes in Claim Check

Hierarchy

Referenced by Excludes2 notes

Clinical classification (CCSR)

Nearest codes

Change history (2)

Reference

Index terms and tables, published questions and FAQ, every source behind this page with its release and checksum, the date-of-service check and the complete change history.

Common coding questions

MedCoder editorial

Can K61.3 be billed directly?

No. K61.3 (Ischiorectal abscess) is a non-billable ICD-10-CM category code. A more specific billable subcode must be selected based on clinical documentation.

Sources for this page

Codes, titles, notes, index terms and mappings on this page are transcribed from the datasets below. Relationships MedCoder computed and text MedCoder wrote are labelled where they appear.

Code, title, tabular notes and index terms Official source data
CMS/CDC ICD-10-CM FY2027 tabular list, index and tables, effective October 1, 2026 Release, file and checksum · Publisher’s page
Claim edits Official source data
CMS Definitions of Medicare Code Edits — v44.0 (October 2026) Release, file and checksum · Publisher’s page
Change history and date-of-service validity Official source data
CMS ICD-10-CM release addenda, ingested release by release into the change ledger Release, file and checksum · Publisher’s page
Comparisons, relationships and the contextual map MedCoder-derived relationship
Computed by MedCoder from the tabular notes and tables above; every derived relationship is marked as derived where it appears
Summary and FAQ answers MedCoder editorial explanation
Written by MedCoder to explain the sources above: drafted with AI assistance, checked by a person against the release files, and labelled as MedCoder text where it appears. Not official text.

Current data releases:ICD-10-CM FY2027 · ICD-10-PCS FY2027 · HCPCS October 2026 · MS-DRG v44 · Medicare Code Editor v44.0 · NCCI PTP Q4 2026 · MUE Q4 2026 · NCD code lists 2026-01 · LCD export September 28, 2026 · All releases and sources

Labels on this page: Official source data · MedCoder-derived relationship · MedCoder editorial explanation. How to read the labels · All data sources and release dates · CMS coding rules

Cite this page

Reference this page in a research guide, syllabus or article. The release is included because code content changes each year.

MedCoder.ai. "K61.3 — Ischiorectal abscess." ICD-10-CM FY2027. https://medcoder.ai/icd10/code/k61.3-ischiorectal-abscess

Change history

  • FY2019 — October 1, 2018
    Became a non-billable header
    FY2019 changes
  • FY2016 — October 1, 2015
    In the code set at ICD-10-CM adoption
    Ischiorectal abscess

Nearest Codes in This Family

Official ICD-10-CM classifications closest to K61.3 in its code family, with their registry titles.

View all codes in the K61 family