ICD 10 Coding Alert

Question: What is the correct ICD-9 code for a mucous fistula encountered during a transverse colectomy performed by our surgeon?

Ohio Subscriber

Answer: Based on the procedure you mention, we'll assume that this is an intestinal fistula. If that is the case, the proper ICD-9 code is 569.81 (Fistula of intestine, excluding rectum and anus).

ICD-9 lists the following fistula site examples for this code: abdominal wall, enterocolic, enteroenteric, ileorectal. The code excludes fistula of intestine to internal organs.

Prepare for ICD-10: You should begin to familiarize yourself with the ICD-10 code set. You'll report the same condition in ICD-10 as K63.2 (Fistula of intestine).

Documentation detail needed: This example points out the need for more complete documentation once ICD-10 is in place. You can see that K63.2 has a large "excludes" list, as follows, and you'd need more information than you provided in your question to ensure that you've selected the proper code:

fistula of duodenum (K31.6)

fistula of intestine with Crohn's disease (K50.013, K50.113, K50.813, K50.913,)

fistula of intestine with ulcerative colitis (K51.013, K51.113, K51.213, K51.313, K51.413, K51.513,K51.813, K51.913)

fistula of anal and rectal regions (K60.-)

fistula of appendix (K38.3)

intestinal-genital fistula, female (N82.2-N82.4)

vesicointestinal fistula (N32.1)