Q42.2 Congenital absence, atresia and stenosis of anus with fistula
The ICD-10-CM code for Congenital absence, atresia and stenosis of anus with fistula is Q42.2 (FY2026). It is a billable, claim-ready diagnosis code.
Classification
- Section
- Q38-Q45: Other congenital malformations of the digestive system (Q38-Q45)
- Category Q42
- 7 codes (6 billable)
- FY2026 Status
- Stable since FY2024
Also Known As
ICD-10-CM Alphabetic Index entries that lead to Q42.2:
- Imperforate (congenital) › anus › with fistula
- Persistence, persistent (congenital) › anal membrane › with fistula
- Absence (of) (organ or part) (complete or partial) › anus (congenital) › with fistula
- Agenesis › anus, anal (canal) › with fistula
- Septum, septate (congenital) › anal › with fistula
- Atresia, atretic › ani, anus, anal (canal) › with fistula
- Impervious (congenital) › anus › with fistula
- Hypoplasia, hypoplastic › anus, anal (canal) › with fistula
U.S. Hospital Utilization
- An estimated 1,110 U.S. inpatient stays in 2023 included Q42.2 among the documented diagnoses.
- 630 stays listed it as the principal diagnosis.
Source: National Inpatient Sample (NIS), Healthcare Cost and Utilization Project (HCUP), Agency for Healthcare Research and Quality, 2016–2023. National survey-weighted estimates.
Official Coding Guidelines
POA indicator for congenital conditions/anomalies and Q00-Q99 exceptionCongenital conditions and anomalies Assign “Y” for congenital conditions and anomalies except for categories Q00- Q99, Congenital anomalies, which are on the exempt list. Congenital conditions are always considered present on admission.
Source: CMS — ICD-10-CM Official Guidelines for Coding and Reporting, FY2026