Chronic gout due to renal impairment, right shoulder, w toph

This diagnosis code signifies a persistent inflammatory arthritis affecting the right shoulder, specifically caused by the accumulation of uric acid crystals (tophi) due to impaired kidney function. The chronic nature indicates a long-standing condition rather than an acute flare-up.

Apply this code when documentation clearly states chronic gout in the right shoulder, explicitly linking its etiology to renal impairment, and noting the presence of tophi. This is appropriate for patients with established kidney disease and a history of gouty arthritis with visible or palpable urate deposits.

• Ensure documentation specifies "chronic" gout and explicitly links it to "renal impairment" as the cause.
• Verify the affected joint is the "right shoulder" and that "tophi" are present.
• Do not use this code for acute gout flares or gout due to other etiologies (e.g., idiopathic).