Drug-induced chronic gout, multiple sites, without tophus

This code signifies a chronic inflammatory arthritis caused by medication, affecting multiple joints, and characterized by the deposition of uric acid crystals without the presence of visible or palpable tophi. The condition results in recurrent episodes of acute pain, swelling, and tenderness in the affected joints due to elevated uric acid levels induced by drug therapy.

Apply this code when documentation clearly indicates chronic gout attributed to a specific drug, affecting more than one joint, and explicitly states the absence of tophaceous deposits. This typically occurs in patients on diuretics, aspirin (low dose), or certain immunosuppressants who develop persistent or recurrent gouty arthritis.

• Ensure the medical record specifies "drug-induced" and "chronic" gout.
• Verify that "multiple sites" are documented, and explicitly confirm "without tophus."
• Always code the adverse effect of the drug (T36-T50 with a 5th or 6th character of 5) as a secondary diagnosis.