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

This diagnosis code signifies a chronic inflammatory arthritis caused by lead toxicity, specifically affecting the left wrist. The presence of tophi indicates advanced disease with subcutaneous or intra-articular urate crystal deposits. This condition is characterized by recurrent acute attacks and chronic joint damage.

Apply this code when documentation clearly states a diagnosis of chronic gout directly attributed to lead exposure, with involvement of the left wrist. The medical record must also confirm the presence of tophi in or around the affected joint. This code is appropriate for established cases of lead-induced gout, not acute flares without chronic features.

• Ensure documentation explicitly links the gout to lead exposure and specifies "chronic" rather than "acute."
• Verify the laterality (left wrist) and the presence of tophi are clearly documented.
• Sequence this code after any codes for lead poisoning (e.g., T56.0X-) if still active, or as a primary diagnosis if the lead exposure is historical but the gout is a direct sequela.