Other secondary chronic gout, multiple sites, with tophus

This diagnosis code signifies a form of chronic gout that has developed secondary to another underlying condition, affecting multiple anatomical locations, and is characterized by the presence of tophi. Tophi are deposits of uric acid crystals that form visible nodules under the skin or in other tissues, indicating long-standing, uncontrolled hyperuricemia. The "other secondary" classification implies that the gout is not due to a specific enzyme defect or renal impairment, which are categorized separately.

This code is appropriate when documentation clearly indicates a patient has chronic gout that is secondary to an identifiable cause (e.g., certain medications, myeloproliferative disorders, psoriasis) and presents with tophaceous deposits in more than one joint or site. The medical record must specify the chronic nature of the condition and the presence of tophi, along with the "multiple sites" involvement.

• Ensure the documentation explicitly states "chronic" gout and the presence of "tophi" at "multiple sites."
• Always sequence the underlying secondary condition first, if known and documented, as this code describes a manifestation of that condition.
• Differentiate from acute gout, which would use codes from the M10 category, and chronic gout without tophi.