Gout ICD-10 CM coding Guide for coders

Basic information on Gout ICD-10 CM codes

Gout is a type of inflammatory arthritis that causes pain and swelling in your joints.  It causes swollen, red, hot and stiff joints. Gout happens when uric acid builds up in your body. ICD-Code M10.9 is a billable ICD-10 code used for healthcare diagnosis reimbursement of Gout, Unspecified.

Corresponding ICD-9 code for Gout is 274.9.

Related ICD-10 CM code description for Gout

M10.0 Idiopathic gout
M10.1 Lead-induced gout
M10.2 Drug-induced gout
M10.3 Gout due to renal impairment
M10.4 Other secondary gout
M10.9 Gout, unspecified
Gout NOS

Category M10, Gout, is further subdivided to distinguish whether it is idiopathic (M10.0-), due to lead (M10.1-), drug induced (M10.2-), due to renal impairment (M10.3-), or other secondary gout (M10.4-). Unspecified gout is coded to M10.9. When the gout is specified to be chronic, it is classified to category M1A, Chronic gout, with seventh characters added to specify with or without tophus (crystallized uric acid deposit under the skin).

Gouty arthritis is a recurrent arthritis of the peripheral joints in which excessive uric acid in the blood is deposited in the joints. Gouty arthritis is classified to idiopathic gout.

Cause of gout

Uric acid is a breakdown product of deoxyribonucleic acid and ribonucleic acid. Humans produce large quantities of uric acid. An excess accumulation of uric acid, which can cause gout, can result from one or more of the following: 

• Protein-rich foods
• Alcohol intake
• Hereditary factors

Typically, people with gout are obese, predisposed to diabetes and hypertension, and at higher risk of heart disease. Gout is more common in affluent societies due to diets rich in proteins, fat, and alcohol.

Signs and symptoms of gout

Gout is characterized by the following signs and symptoms:

• Excruciating, sudden, unexpected, and burning pain
• Swelling
• Redness, warmth, and stiffness in the affected joint
• Low-grade fever

Gout commonly occurs in the toe; however, it can also appear in other parts of the body.

Patients usually suffer from two sources of pain:

• Crystals inside the joint that cause intense pain whenever the affected area is moved.
• Inflammation of the tissues around the joint that causes the skin to be swollen, tender, and sore when slightly touched. For example, a blanket or even the lightest sheet draping over the affected area could cause extreme pain.

Gout usually affects the big toe; however, it can also affect other joints, such as the ankle, heel, instep, knee, wrist, elbow, fingers, and spine. In some cases, gout may appear in the joints of small toes that have become immobile due to an injury earlier in life that causes poor circulation. This poor circulation can sometimes lead to gout. 

 

Prevention of or treatment for gout

The serum level of uric acid is the primary risk factor for gout. The serum level is the result of both intake (diet) and output (excretion). 

Someone with gout should have a diet that is low in fat and protein. A 2004 study examined 40,000 men over a 12-year time frame. During this time, 730 new cases of gout were reported.

Increased meat intake was associated with an increased risk of gout, according to the study. However, high-purine vegetable sources (e.g., asparagus, cauliflower, spinach, and green peas) did not increase the risk of developing gout, the study found. Dairy products, such as milk and cheese, significantly reduced one’s chances of developing gout. A diet low in purines reduces the serum level of uric acid unless these levels are caused by other health conditions that do not respond to dietary changes.

Beer consumption is associated with a 49% increase in relative risk per daily 12-ounce serving. By contrast, beer consumption was associated with only a 15% increase in relative risk.

Related Gout ICD 10 code Synonyms include

• Gout
• Gouty tophi
• Gouty tophi of heart
• Gouty tophi of left ear
• Gouty tophi of left elbow
• Gouty tophi of left foot
• Gouty tophi of left hand
• Gouty tophi of left olecranon bursa
• Gouty tophi of right ear
• Gouty tophi of right elbow
• Gouty tophi of right foot
• Gouty tophi of right hand
• Gouty tophi of right olecranon bursa
• Gouty tophus
• Gouty tophus of left ear
• Gouty tophus of left elbow
• Gouty tophus of left foot
• Gouty tophus of left hand
• Gouty tophus of left olecranon bursa
• Gouty tophus of right ear
• Gouty tophus of right elbow
• Gouty tophus of right foot
• Gouty tophus of right hand
• Gouty tophus of right olecranon bursa

Basic ICD-10 INFORMATION

World Health Organization (WHO) authorized the publication of the International Classification of DiseasesExternal 10th Revision (ICD-10), which was implemented for mortality coding and classification from death certificates in the U.S. in 1999. The U.S. developed a Clinical Modification (ICD-10-CM) for medical diagnoses based on WHO’s ICD-10.  This medical classification list is generated by the World Health Organization (WHO), and is used to help healthcare providers identify and code health conditions.

ICD-10 is required for use by physicians and healthcare providers under the Health Insurance Portability & Accountability Act (HIPAA) and will replace all ICD-9 code sets. There are nearly 5 times as many diagnosis codes in ICD-10-CM than in ICD-9-CM.ICD-10 has alphanumeric categories instead of numeric ones.