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K62.81 ICD-10-CM Code: Anal sphincter tear (healed) (nontraumatic) (old)

Compare with another codeCheck this code on a claim

Billing Status: YES. This is a valid, specific, and billable ICD-10-CM reference.

Coding at a Glance

Tabular directives
2 inclusion terms · 7 Excludes2 · 1 use-additional code

Billable · FY2027A valid, specific ICD-10-CM code, reportable for dates of service in FY2027.

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; the Instructions section marks which is which.

Use additional codeReport with this code when documented
  • code for any associated fecal incontinence (R15.-)
Excludes2Not included here; may be reported together
  • anal fissure (K60.-)
  • anal sphincter tear (healed) (old) complicating delivery (O34.7-)
  • traumatic tear of anal sphincter (S31.831)
  • ulcerative proctitis (K51.2)

+3 more in Instructions

IncludesWhat this code covers
  • anal canal
  • Tear of anus, nontraumatic

Most relevant related codes MedCoder-derived

Read off the official notes above and this code’s own position in the tabular list. Which to report is a documentation question; Compare shows the two side by side.

CompareCheck ClaimView Related Codes

Inpatient Payment Groups (MS-DRG)

Potential MS-DRG participation — not a DRG assignment.

MS-DRGs this diagnosis helps define, as principal or secondary, per the CMS ICD-10-CM/PCS MS-DRG Definitions Manual v44, Appendix B.

  • MS-DRG 393 — OTHER DIGESTIVE SYSTEM DIAGNOSES WITH MCC (MDC 06)
  • MS-DRG 394 — OTHER DIGESTIVE SYSTEM DIAGNOSES WITH CC (MDC 06)
  • MS-DRG 395 — OTHER DIGESTIVE SYSTEM DIAGNOSES WITHOUT CC/MCC (MDC 06)

A diagnosis appearing in a group's logic does not by itself determine the DRG assigned to a stay; the grouper uses the full claim.

Coding instructions

Official Tabular Instructional Notes: the inclusion, exclusion and sequencing notes published for K62.81 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 K62.81 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.

  • anal canal

Source: inherited from K62

Inclusion Terms

Alternative terms the tabular list files under this code.

  • Tear of anus, nontraumatic

Excludes2 — Not Included Here

Conditions not covered by this code, but which may be reported alongside it when both are present.

Use Additional Code

Supplementary codes the tabular list directs you to add.

  • Use additional code for any associated fecal incontinence (R15.-)

Coder workflow for K62.81

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

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).
The conditions the Use Additional Code note names
Reported with this code when documented; a conditional instruction (“if applicable”, “if known”) applies only when the record supports it.

Official instructions as workflow

  • Excludes2 — not part of K62.81(7 notes)

    Coding workflow: The conditions named in this note are not included in K62.81. When the record documents both, both may be reported; the note is a boundary, not a prohibition.

    CompareK60, O34.7, S31.831, K51.2, K94.0, K94.1

    See the official tabular notes · Guidelines I.A.12.b

  • Use Additional Code — after identifying K62.81(1 note)

    Coding workflow: Check whether the documentation supports the additional code(s) the note names, and report them with K62.81 when it does. Where the instruction is conditional (“if applicable”, “if known”), it applies only when the record documents the condition.

    ReviewR15

    See the official tabular notes · Guidelines I.A.13

Coding decision scenarios

Pattern scenarios for this code’s structure — decision rules, not clinical cases

Documentation: A condition the Use Additional Code note names is documented.

Coding question: Is a second code reported with K62.81?

Path: Review the Use Additional Code note and the code it names.

Reason: The additional code is reported when the record documents the condition; a conditional instruction applies only when its condition is met (Guidelines I.A.13).

ReviewR15

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.

Don’t confuse K62.81 with…

MedCoder analysis — pairs from this code’s official notes, distinctions written by MedCoder

The codes most likely to be picked instead of K62.81 — named in its own official notes, or sharing its laterality or encounter family — with what separates them and which documentation moves the case. Each links to the full comparison.

  • K60— Excludes2 relationship (Informational)

    Distinct conditions — both may be reported.

    A distinct condition — both may be reported when both are documented.

    What moves you there: Documentation of anal fissure adds K60; it is not part of this code and both may be reported when both are documented.

    Full comparison: K62.81 vs K60 →

  • O34.7— Excludes2 relationship (Informational)

    Distinct conditions — both may be reported.

    A distinct condition — both may be reported when both are documented.

    What moves you there: Documentation of anal sphincter tear (healed) (old) complicating delivery adds O34.7; it is not part of this code and both may be reported when both are documented.

    Full comparison: K62.81 vs O34.7 →

  • S31.831— Excludes2 relationship (Informational)

    Distinct conditions — both may be reported.

    A distinct condition — both may be reported when both are documented.

    What moves you there: Documentation of traumatic tear of anal sphincter adds S31.831; it is not part of this code and both may be reported when both are documented.

    Full comparison: K62.81 vs S31.831 →

  • K51.2— Excludes2 relationship (Informational)

    Distinct conditions — both may be reported.

    A distinct condition — both may be reported when both are documented.

    What moves you there: Documentation of ulcerative proctitis adds K51.2; it is not part of this code and both may be reported when both are documented.

    Full comparison: K62.81 vs K51.2 →

  • K94.0— Excludes2 relationship (Informational)

    Distinct conditions — both may be reported.

    A distinct condition — both may be reported when both are documented.

    What moves you there: Documentation of colostomy and enterostomy malfunction adds K94.0; it is not part of this code and both may be reported when both are documented.

    Full comparison: K62.81 vs K94.0 →

  • K94.1— Excludes2 relationship (Informational)

    Distinct conditions — both may be reported.

    A distinct condition — both may be reported when both are documented.

    What moves you there: Documentation of colostomy and enterostomy malfunction adds K94.1; it is not part of this code and both may be reported when both are documented.

    Full comparison: K62.81 vs K94.1 →

Relationships are read from this code's own official notes, its laterality siblings and its encounter family; the wording of each distinction is MedCoder editorial, and the documentation named in each “what moves you there” line is the official note phrase or sibling title itself. Source: CMS ICD-10-CM tabular instructional notes; ICD-10-CM Official Guidelines, Section I.A.12.a.

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

Anal sphincter tear (healed) (nontraumatic) (old) is a billable ICD-10-CM diagnosis code (K62.81).

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

Official Coding Guidelines

No excerpt in the ICD-10-CM Official Guidelines names this code specifically. Its chapter carries only this chapter-wide note:

Chapter 11: Diseases of the Digestive System (K00-K95)

Reserved for future guideline expansion

Verify Before Coding

  • No Medicare Code Editor or MS-DRG Definitions Manual restrictions apply to this code.

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 K62.81 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 1 Excludes2 note: K60 — Fissure and fistula of anal and rectal regions.

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

MS-DRG Grouper Relationships (FY2027)

Potential MS-DRG participation — not a DRG assignment.

FY2027 MS-DRG: not on the CMS CC/MCC list — as a secondary diagnosis this code does not change MS-DRG severity for that release.

Named in the grouper logic of 3 MS-DRGs: DRG 393 (MDC 06), DRG 394 (MDC 06), DRG 395 (MDC 06).

From the CMS MS-DRG Definitions Manual (Appendices B and C). Actual DRG assignment depends on the complete claim.

Clinical classification (AHRQ CCSR):DIG015 — Anal and rectal conditions (default).

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 category (Anal and rectal conditions).

K60.523 — Anorectal fistula, complex, recurrent, K60.529 — Anorectal fistula, complex, unspecified, K61.0 — Anal abscess, K61.1 — Rectal abscess, K61.2 — Anorectal abscess, K61.3 — Ischiorectal 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, K62.7 — Radiation proctitis, K62.82 — Dysplasia of anus, K62.89 — Other specified diseases of anus and rectum, K62.9 — Disease of anus and rectum, unspecified, +38 more

Same Index main term, other category

The ICD-10-CM Index to Diseases and Injuries files this code under the main term “Tear, torn”; these codes share that main term but sit in a different category of the Tabular List.

G96.11 — Dural tear (dural, nontraumatic), G97.41 — Accidental puncture or laceration of dura during a procedure (dural), M51.35 — Other intervertebral disc degeneration, thoracolumbar region (annular fibrosis), M75.10 — Unspecified rotator cuff tear or rupture, not specified as traumatic (rotator cuff), M75.11 — Incomplete rotator cuff tear or rupture not specified as traumatic (rotator cuff, incomplete), M75.12 — Complete rotator cuff tear or rupture not specified as traumatic (rotator cuff, complete), N88.1 — Old laceration of cervix uteri (cervix, old), O08.6 — Damage to pelvic organs and tissues following an ectopic and molar pregnancy (bowel, with ectopic or molar pregnancy), O69.89 — Labor and delivery complicated by other cord complications (umbilical cord, complicating delivery), O70.0 — First degree perineal laceration during delivery (vulva, complicating delivery), O70.1 — Second degree perineal laceration during delivery (pelvic, floor, complicating delivery), O70.20 — Third degree perineal laceration during delivery, unspecified (anus, anal, complicating delivery, with third degree perineal laceration), O70.3 — Fourth degree perineal laceration during delivery (anus, anal, complicating delivery, with third degree perineal laceration, with mucosa), O70.4 — Anal sphincter tear complicating delivery, not associated with third degree laceration (anus, anal, complicating delivery, without third degree perineal laceration), O71.3 — Obstetric laceration of cervix (cervix, obstetrical trauma), O71.5 — Other obstetric injury to pelvic organs (bladder, obstetrical), O71.6 — Obstetric damage to pelvic joints and ligaments (broad ligament, obstetrical trauma), O71.82 — Other specified trauma to perineum and vulva (periurethral tissue, obstetrical trauma), O90.1 — Disruption of perineal obstetric wound (perineal, secondary), P10.4 — Tentorial tear due to birth injury (tentorial, at birth), +14 more

Lab tests where this diagnosis supports Medicare coverage (NCD)

Medicare's National Coverage Determination (NCD) program lists this diagnosis as medical justification for these lab tests.

Fecal Occult Blood Test (FOBT)

Contextual Map

Every relationship of K62.81 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 K62.81 with these 4 related codes in Claim Check

Hierarchy

Excludes2

Use Additional Code

  • R15 — Fecal incontinence[Use Additional Code]: “code for any associated fecal incontinence (R15.-)”— CMS ICD-10-CM tabular instructional notes · icd10cm-fy2027

Referenced by Excludes2 notes

Clinical classification (CCSR)

MS-DRG Grouper

MDC crossing

  • MDC 06 — Diseases and Disorders of the Digestive System[MDC crossing]: “Diseases and Disorders of the Digestive System — the grouper's crossing between diagnoses and procedures: a principal diagnosis sets the MDC, and same-MDC procedures move the stay to its surgical DRGs. 5,748 same-MDC procedures group here; browse them on the MDC page.”— CMS MS-DRG Definitions Manual · FY2027

Index entries

  • Tear, torn (traumatic), anus, anal (sphincter), nontraumatic (healed) (old)[Index term]— CMS ICD-10-CM Index to Diseases and Injuries · icd10cm-fy2027

Nearest codes (13)

Change history

  • FY2016 — In the code set at ICD-10-CM adoption [Change history]— CMS release files (code change ledger) · icd10cm-fy2016

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.

Indexed Clinical Terms (1)

Official source data — entries quoted as published, in the Index’s own lookup phrasing

Clinical term phrases from the official ICD-10-CM Index to Diseases and Injuries that map to this code. These are alphabetic-index entries shown as the Index writes them — lookup phrasing, not necessarily the wording of a final diagnosis.

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
Coding guidelines Official source data
ICD-10-CM Official Guidelines for Coding and Reporting (FY2027), quoted by section 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
Inpatient payment groups Official source data
CMS MS-DRG Definitions Manual (incl. Appendix B diagnosis index, Appendix C CC/MCC list, Appendix E procedure index) and IPPS Final Rule tables — v44 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. "K62.81 — Anal sphincter tear (healed) (nontraumatic) (old)." ICD-10-CM FY2027. https://medcoder.ai/icd10/code/k62.81-anal-sphincter-tear-healed-nontraumatic-old

Change history

  • FY2016 — October 1, 2015
    In the code set at ICD-10-CM adoption
    Anal sphincter tear (healed) (nontraumatic) (old)

No changes since FY2016 — additions, deletions, description changes and billable-status changes are tracked through FY2027, and none are recorded for this code. Note changes are tracked from FY2027 only.

Nearest Codes in This Family

Official ICD-10-CM classifications closest to K62.81 in its code family, with their registry titles.

View all codes in the K62 family