Gout due to renal impairment, multiple sites

This diagnosis code signifies a form of gout specifically caused by impaired kidney function, affecting more than one anatomical location. It indicates the presence of uric acid crystal deposition in multiple joints or tissues, directly attributable to the kidneys' inability to adequately excrete uric acid.

Apply this code when documentation clearly states gout is present in multiple sites (e.g., knees and ankles) and explicitly links its etiology to renal impairment or chronic kidney disease. Supporting documentation should include physician notes detailing the diagnosis of gout, the affected sites, and the underlying renal dysfunction.

• Ensure the documentation specifies "multiple sites" for gout; otherwise, a site-specific code may be more appropriate.
• Always code the underlying renal condition (e.g., CKD stage) as a secondary diagnosis.
• Distinguish from primary gout or gout due to other secondary causes (e.g., drug-induced) by reviewing the physician's assessment of etiology.