Chronic gout due to renal impairment, unsp site, w/o tophus

This code signifies a persistent form of gout that arises as a direct consequence of impaired kidney function. It specifically indicates that the affected joint or joints are not specified, and there is no evidence of tophi (urate crystal deposits) present. The condition is characterized by recurrent episodes of acute inflammatory arthritis.

Use this code when documentation clearly links chronic gout to underlying renal impairment, without specifying the anatomical site of the gout attack and explicitly stating the absence of tophi. This code is appropriate for patients with a confirmed diagnosis of chronic gout where kidney disease is identified as the etiologic factor. Supporting documentation would include physician notes detailing chronic gout, a diagnosis of renal impairment, and the absence of tophi.

• Always sequence the underlying renal impairment code first, as it is the etiology of the gout.
• Ensure documentation explicitly states "without tophus" or "no tophi" to justify using this specific code.
• Avoid using this code if the anatomical site of the gout is specified; instead, use a more specific M1A.3- subcategory.