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

This code signifies a persistent form of gout that has developed as a consequence of impaired kidney function, affecting an unspecified hip joint. The diagnosis specifically indicates the absence of visible or palpable tophi (gouty deposits) in or around the affected joint.

Apply this code when documentation clearly states chronic gout caused by renal impairment, with symptoms localized to the hip, and explicitly notes the absence of tophi. This code is appropriate for patients with a confirmed diagnosis of chronic gout secondary to kidney disease, where the specific hip involved is not documented.

• Always code the underlying renal impairment first, followed by this code.
• Do not use this code if the documentation specifies a particular hip (e.g., right or left); instead, use the more specific anatomical site code.
• Ensure the medical record explicitly states "without tophus (tophi)" to support the final digit of the code.