Lead-induced chronic gout, unspecified shoulder, with tophus

This code signifies chronic gout that is specifically caused by lead exposure, affecting an unspecified shoulder joint. The presence of tophi, which are deposits of uric acid crystals, confirms the chronic nature and severity of the condition. This diagnosis indicates a systemic metabolic disorder with a specific environmental etiology.

Use this code when documentation clearly states a diagnosis of chronic gout with a confirmed link to lead exposure. The patient must present with symptoms and signs localized to an unspecified shoulder, and the presence of tophi must be explicitly noted. This code is appropriate when the laterality of the affected shoulder is not specified in the medical record.

• Ensure documentation explicitly links the gout to lead exposure; otherwise, a different etiology code for gout would be more appropriate.
• Verify the presence of tophi is documented, as this distinguishes it from gout without tophi.
• If the specific shoulder (right or left) is documented, a more specific code from the M1A.11 category should be used.