Lead-induced chronic gout, right wrist, with tophus (tophi)

This code signifies chronic inflammatory arthritis caused by lead toxicity, specifically affecting the right wrist joint. The presence of tophi, which are deposits of uric acid crystals, further characterizes this advanced stage of gout.

Apply this code when documentation clearly indicates a diagnosis of chronic gout directly attributed to lead exposure, with the right wrist identified as the affected joint, and the presence of tophaceous deposits. Supporting documentation would include a history of lead exposure, elevated lead levels, and clinical findings consistent with chronic gout and tophi in the right wrist.

• Ensure documentation explicitly links the gout to lead exposure; otherwise, a different etiology of gout should be coded.
• Verify the laterality (right wrist) and the presence of tophi are clearly stated in the medical record.
• Do not use this code for acute gout or chronic gout without tophi, even if lead-induced.