What is the appropriate ICD-10 (International Classification of Diseases, 10th Revision) code for recurrent gout affecting the toes, elbows, shoulders, and wrist?

ICD-10 Coding for Recurrent Gout Affecting Multiple Joints

The appropriate ICD-10 code for recurrent gout affecting multiple joints (toes, elbows, shoulders, and wrist) is M1A.00 - Idiopathic chronic gout, unspecified site, without tophus (tophi).

Understanding Gout Coding in ICD-10

Gout in ICD-10 is primarily coded using two categories:

• M10 codes: For acute gout
• M1A codes: For chronic (recurrent) gout

Since the question specifically mentions "recurrent gout," the appropriate category is M1A, which represents chronic gout.

Coding Algorithm for Gout

1. Determine if acute or chronic/recurrent

   • Acute gout: Use M10 codes
   • Chronic/recurrent gout: Use M1A codes

2. Identify the specific type of gout

   • Idiopathic gout: M1A.0
   • Lead-induced gout: M1A.1
   • Drug-induced gout: M1A.2
   • Gout due to renal impairment: M1A.3
   • Other secondary gout: M1A.4

3. Specify affected site(s)

   • When multiple sites are affected as in this case (toes, elbows, shoulders, and wrist), the appropriate code is for "multiple sites" or "unspecified site" depending on documentation specifics

4. Document presence or absence of tophi

   • Without tophi: Final digit 0
   • With tophi: Final digit 1

Rationale for Code Selection

The code M1A.00 is appropriate because:

1. The condition is described as "recurrent gout," indicating chronicity
2. No specific cause is mentioned (such as medication-induced or secondary to another condition), so "idiopathic" is assumed
3. Multiple joints are affected across different body regions
4. No mention of tophi is made in the description

Alternative Coding Options

If more specific documentation is available, consider:

• M1A.09 - If documentation specifically states "multiple sites" rather than "unspecified site"
• M1A.01 - If tophi are present (not mentioned in the question)
• Site-specific codes - If documentation supports coding each joint separately:
  • M1A.071/M1A.072 for ankle and foot (including toes)
  • M1A.021/M1A.022 for elbow
  • M1A.011/M1A.012 for shoulder
  • M1A.031/M1A.032 for wrist

Important Considerations

• Proper documentation of all affected sites is crucial for accurate coding
• The presence or absence of tophi should be documented to select the correct final digit
• If the gout is secondary to another condition or medication, a different code from the M1A series would be appropriate

This coding recommendation aligns with current guidelines for gout classification in ICD-10 1.