Alphabetic Index FY2027

N36.0

Urethral fistula

FY2027Chapter 14: Diseases of the genitourinary system/N30–N39 Other diseases of the urinary system

BillableComplete code, valid to report
Care settingsHome Health Primary · MMTA - Gastrointestinal tract and Genitourinary systemHospital CC

N36.0 (also written N360) is a billable ICD-10-CM diagnosis code for urethral fistula. It is part of the FY2027 code set, effective October 1, 2026. It is one of the 10 codes in category N36 (Other disorders of urethra). The Alphabetic Index lists it under 6 entries. Its coding notes include 3 Excludes1 entries and 11 Excludes2 entries.

Excludes1

Not coded here. The listed conditions generally should not be reported together.

This code
  • urethroscrotal fistula (N50.89)
  • urethrovaginal fistula (N82.1)
  • urethrovesicovaginal fistula (N82.1)

Excludes2

Not included here. Both codes may be reported if the patient has both conditions.

Also from chapter/block level (11 notes)
Inherited from N30–N39 Other diseases of the urinary system
  • urinary infection (complicating):
    • abortion or ectopic or molar pregnancy (O00-O07, O08.8)
    • pregnancy, childbirth and the puerperium (O23.-, O75.3, O86.2-)
Inherited from Chapter 14 Diseases of the genitourinary system
  • certain conditions originating in the perinatal period (P04-P96)
  • certain infectious and parasitic diseases (A00-B99)
  • complications of pregnancy, childbirth and the puerperium (O00-O9A)
  • congenital malformations, deformations and chromosomal abnormalities (Q00-Q99)
  • endocrine, nutritional and metabolic diseases (E00-E88)
  • injury, poisoning and certain other consequences of external causes (S00-T88)
  • neoplasms (C00-D49)
  • symptoms, signs and abnormal clinical and laboratory findings, not elsewhere classified (R00-R94)

Care settings

How CMS programs treat this code. These are CMS claim edits and list entries, not coverage or eligibility rules.

Home Health Primary

Accepted as the primary (principal) diagnosis on a home health claim. The Home Health Grouper assigns it to the MMTA - Gastrointestinal tract and Genitourinary system clinical group.

Source: CMS Home Health Grouper Software v07.2.26, effective October 1, 2026

Hospital CC

Counts as a complication or comorbidity (CC) when reported as a secondary diagnosis on an inpatient claim. It does not count when the principal diagnosis is one of the 123 codes in its exclusion list. Some MS-DRGs also ignore a CC or MCC that defines the DRG.

Source: CMS MS-DRG Definitions Manual v44, effective October 1, 2026, Appendix C

Inclusion terms

Conditions classified to this code.

This code
  • Urethroperineal fistula
  • Urethrorectal fistula
  • Urinary fistula NOS

Alphabetic Index terms

Terms the official Alphabetic Index lists for this code. 6 entries