Patient presents with complaints consistent with rectal fistula, including anal pain, perirectal abscess, purulent drainage, and bleeding.  On physical examination, a palpable fistula tract is noted in the perianal region.  Digital rectal examination reveals tenderness and induration.  The patient reports a history of recurrent anorectal abscesses.  Differential diagnoses considered include anal fissure, pilonidal cyst, Crohn's disease, and hidradenitis suppurativa.  Assessment includes evaluation for anorectal fistula, fistula-in-anus, complex fistula, and rectovaginal fistula if applicable.  Symptoms such as perianal discharge, skin irritation, and fecal incontinence were also documented.  Diagnostic imaging, including MRI or endoanal ultrasound, may be ordered to delineate the fistula tract and evaluate for any associated abscesses.  Treatment options, including fistulotomy, seton placement, fibrin glue injection, or advancement flap procedures, were discussed with the patient.  Patient education was provided regarding proper wound care, pain management, and potential complications, such as recurrence or incontinence.  Follow-up appointments were scheduled for postoperative care and assessment of healing progress.  ICD-10 code K60.3 (anal and rectal fistula) and relevant CPT codes for the chosen procedure will be documented for medical billing and coding purposes.