Drug-induced chronic gout, right shoulder, with tophus

This code signifies chronic gout that has been induced by medication, specifically affecting the right shoulder joint. The presence of a tophus (or tophi) indicates a more advanced stage of gout where urate crystals have deposited in soft tissues.

Apply this code when documentation clearly states drug-induced chronic gout impacting the right shoulder and explicitly mentions the presence of tophi. This typically occurs in patients with a history of medication use known to precipitate gout, such as diuretics or aspirin, and presenting with chronic joint pain and visible or palpable tophaceous deposits.

• Ensure documentation specifies "drug-induced" and identifies the right shoulder as the affected joint.
• Verify the presence of "tophus" or "tophi" in the clinical notes; otherwise, a code without tophi should be used.
• Code the specific drug causing the gout as an adverse effect (T36-T50 with a 5th or 6th character of 5) as an additional diagnosis.