Chronic gout due to renal impairment, left hand, with tophus

This code signifies a chronic inflammatory arthritis affecting the left hand, specifically caused by elevated uric acid levels due to impaired kidney function. The presence of tophi, which are deposits of uric acid crystals, further characterizes this condition.

Apply this code when documentation clearly indicates chronic gout in the left hand, directly attributed to renal impairment, and explicitly mentions the presence of tophaceous deposits. This typically occurs in patients with long-standing kidney disease and poorly controlled hyperuricemia.

• Ensure documentation specifies "chronic" gout and a causal link to "renal impairment."
• Verify the laterality is "left hand" and the presence of "tophus" or "tophi" is documented.
• Do not use this code for acute gout, gout due to other causes, or gout without tophi.