Other secondary chronic gout, multiple sites, without tophus

This code signifies a form of chronic gout that is secondary to another underlying condition, affecting multiple joints throughout the body. Importantly, this diagnosis specifies the absence of tophi, which are characteristic urate crystal deposits. The chronic nature indicates persistent or recurrent inflammatory arthritis due to uric acid crystal deposition.

Apply this code when documentation clearly states "secondary chronic gout" involving more than one joint, and explicitly notes the absence of tophi. This is appropriate for patients with established chronic gout secondary to conditions like renal insufficiency, myeloproliferative disorders, or certain medications, where multiple joints are symptomatic without visible tophaceous deposits.

• Ensure documentation specifies "secondary" gout; otherwise, consider primary gout codes.
• Verify the absence of tophi is explicitly stated or clearly implied; if tophi are present, a different code is required.
• Always code the underlying secondary condition first, as it is the etiology for this gout.