This coding and reimbursement resource is intended for healthcare providers and their billing and coding teams.
Coding and Reimbursement Information
The table below includes examples of codes that may be applicable when billing for the treatment of transsphincteric fistulas and is not intended to be an exhaustive list or a recommendation regarding coding for any particular patient, procedure, or claim.
Code |
Description |
| ICD 10 | |
| K60.32 | This code is for a complex anal fistula that is transsphincteric. |
| K60.52 | This code is for a complex anorectal fistula that is transsphincteric. |
| K60.323 | Anal fistula, complex, recurrent. |
| CPT | |
| 46280 | Surgical treatment of anal fistula (fistulectomy/fistulotomy); transsphincteric, suprasphincteric, extrasphincteric, or multiple, including placement of seton. |
| APC | |
| 5313 | Level 3 lower GI procedures. |
For more about the BioHealx® technology for treating transsphincteric anal fistulas, see our Our Technology page.
Provided for Informational and Educational Purposes Only
The coding and reimbursement information provided is for informational and educational purposes only and is not intended to provide legal, reimbursement, coding, or medical advice. Coding and coverage policies are subject to change and may vary by payer, geographic region, and individual patient circumstances. Healthcare providers are responsible for determining the appropriate codes, documenting services rendered, and submitting claims based on services actually performed in accordance with applicable laws, regulations, and payer requirements. Coverage and payment are not guaranteed. Providers should consult the relevant payer policies and other authoritative sources to verify coding, coverage, and payment information.