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

This diagnosis code signifies a chronic inflammatory arthritis of the left wrist caused by a medication, characterized by the presence of urate crystal deposits (tophi). This condition results from prolonged elevated uric acid levels due to drug side effects, leading to recurrent acute gout attacks and eventual tophus formation.

Apply this code when documentation explicitly states drug-induced chronic gout affecting the left wrist, and physical examination or imaging confirms the presence of tophi. This code is appropriate when a specific medication is identified as the causative agent for the sustained hyperuricemia and subsequent chronic gouty arthritis.

• Ensure the documentation clearly links the chronic gout to a specific drug and specifies "left wrist" and "with tophus."
• Do not use this code for acute drug-induced gout or chronic gout without tophi, even if drug-induced.
• Code the adverse effect of the drug (T36-T50 with 5th or 6th character 5) as an additional diagnosis to fully capture the etiology.