Chronic gout due to renal impairment, right wrist, w/o toph

This diagnosis code signifies chronic inflammatory arthritis caused by uric acid crystal deposition in the right wrist, specifically resulting from impaired kidney function. The absence of tophi indicates that there are no visible or palpable subcutaneous nodules of urate crystals. This condition is persistent rather than an acute flare.

Apply this code when documentation clearly states chronic gout affecting the right wrist, with a direct causal link to renal impairment. The patient's medical record should confirm the chronicity of the gout and the presence of kidney disease as the underlying etiology. This code is appropriate when tophi are explicitly noted as absent.

• Ensure documentation specifies "chronic" gout and explicitly links it to "renal impairment."
• Verify the affected joint is the "right wrist" and that "tophi" are not present.
• Code any underlying chronic kidney disease (CKD) separately, as it is the causal factor.