Chronic gout due to renal impairment, l shoulder, w/o toph

This code signifies a persistent inflammatory arthritis caused by the accumulation of uric acid crystals in the left shoulder joint, specifically resulting from impaired kidney function. The absence of tophi (visible uric acid deposits) distinguishes this presentation.

Apply this code when documentation clearly indicates chronic gout affecting the left shoulder, with the etiology explicitly linked to renal impairment. The patient's medical record should confirm the absence of tophaceous deposits.

• Always code the underlying renal impairment first, as it is the causal condition.
• Ensure documentation specifies "chronic" gout and the "left shoulder" joint.
• Distinguish from acute gout or gout with tophi, which have different code assignments.