Drug-induced chronic gout, multiple sites, with tophus

This code signifies a chronic inflammatory arthritis caused by elevated uric acid levels due to medication, affecting multiple joints, and characterized by the presence of urate crystal deposits (tophi). It represents a persistent form of gout where drug therapy is identified as the underlying cause.

Apply this code when documentation clearly indicates chronic gout precipitated by a specific drug, affecting more than one joint, and physical examination or imaging confirms the presence of tophi. This code is appropriate when the drug-induced nature and chronic, polyarticular, tophaceous presentation are explicitly stated.

• Requires documentation of the specific drug causing the gout.
• Distinguish from acute drug-induced gout (M10.2-) or chronic gout without tophi (M1A.09X-).
• Always sequence the drug code (T36-T50 with 5th or 6th character 5) as a secondary diagnosis to identify the causative medication.