Is ICD-10-CM code K61 billable?

No, K61 (Abscess of anal and rectal regions) is a non-billable ICD-10-CM code. It must be coded to a more specific subcategory before it can be used for reimbursement.

What chapter does ICD-10-CM code K61 belong to?

K61 belongs to Chapter 11 of the ICD-10-CM tabular list: K00–K95 (Diseases of the Digestive System).

K61Not billable, use a more specific code below

Abscess of anal and rectal regions

In Other diseases of intestines (K55-K64), chapter 11: Diseases of the Digestive System

7 billable codes under K61: 4 are a CC; none map to an HCC.A CC or MCC (major CC) is a secondary diagnosis that raises the MS-DRG payment.

Instructional notes

Includes: conditions that are coded here

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

Official coding guidelines

From the ICD-10-CM Official Guidelines for Coding and Reporting, FY 2027 (CMS and NCHS). Links open the PDF at the right page.

There are no chapter-specific rules for Chapter 11 yet, so the general rules in Section I.B apply.

Read Section I.C.11 (page 58)

All codes under K61

K61 can't be used on a claim. Pick a billable code below; grey headings group them.

K61 MS-DRGs

As the principal diagnosis, all 7 billable codes under K61 group to MS-DRG 393, 394, 395, 791, or 793 (v44.0). Which one applies depends on procedures performed, secondary diagnoses (CC/MCC), and the patient's age and discharge status.

Other codes that refer to K61

Notes on these codes point to K61.

K60 Excludes2: abscess or cellulitis of anal and rectal regions (K61.-)
K63.0 Excludes2: abscess of anal and rectal regions (K61.-)
L02 Excludes2: abscess of anus and rectal regions (K61.-)
L03 Excludes2: cellulitis of anal and rectal region (K61.-)
L03.31 Excludes2: cellulitis of anal and rectal regions (K61.-)

About the condition

Plain-language background from MedlinePlus (National Library of Medicine), not coding guidance.

Abscess

An abscess is a pocket of pus. You can get an abscess almost anywhere in your body. When an area of your body becomes infected, your body's immune system tries to fight the infection. White blood cells go to the infected area, collect within the damaged tissue, and cause inflammation. During this process, pus forms. Pus is a mixture of living and dead white blood cells, germs, and dead tissue.

Anal Disorders

Your anus is the opening at the end of your large intestine. It is where stool (poop) leaves your body. Problems with the anus are common. They include:

Code history

Valid since FY2016, when ICD-10-CM took effect on October 1, 2015. No changes since.