Other secondary chronic gout, unsp site, without tophus

This code signifies a persistent form of gout that is a consequence of another underlying medical condition or medication, but the specific anatomical location of the gouty arthritis is not documented. It specifically indicates the absence of tophi, which are deposits of uric acid crystals.

Apply this code when documentation clearly states "secondary chronic gout" without specifying a joint or body region, and explicitly notes the absence of tophi. This is appropriate when the chronic gout is attributed to a secondary cause (e.g., renal insufficiency, certain diuretics) rather than being primary.

• Ensure documentation specifies "chronic" gout and explicitly states "without tophi."
• Do not use if a specific joint or site of involvement is documented; instead, use a more specific M1A.4- subcategory.
• Always code the underlying secondary condition first, followed by this code.