ICD-10 Codes for Documenting the Chronic Symptoms of Gout

Gout causes severe pain, swelling and stiffness in the joints. This article details the symptoms, causes and treatment options along with the ICD-10 codes.

1. ICD-10 Codes for
Documenting the Chronic
Symptoms of Gout
Gout causes severe pain, swelling and stiffness in the joints. This article
details the symptoms, causes and treatment options along with the
ICD-10 codes.
Outsource Strategies International
United States

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According to recent reports (2019 statistics), Gout affects about 8.3 million
people in the United States. Regarded as a complex form of inflammatory
arthritis that can affect anyone, Gout is characterized by sudden and severe
attacks of pain, swelling, tenderness and redness in the joints. Sudden and
intense gout attacks – often first felt at the base of the big toe, can make it
feel like your foot is on fire. It can also be felt in the ankles, knees, heels,
wrists, fingers and elbows. Gout attacks occur suddenly and keep returning
over time, slowly harming tissues in the region of the inflammation. Initially,
these attacks get better quickly within days. Later, attacks occur more often
and last for more time. Chronic gout is treated using medications that lower
the uric acid level in the body. If left untreated, the rheumatology condition
can cause irreversible joint damage, kidney problems, and tophi (a deposit
of crystalline uric acid at the surface of joints or cartilage). Managing this
condition can be quite challenging as there are different stages through
which the condition progresses and these are considered as the different
types of gout. As physicians focus on their patients, outsourced medical
billing and coding services can ensure accurate and proper reporting of
services for appropriate reimbursement.
Gout occurs when urate crystals gets accumulated in your joint causing
severe pain and inflammation. Urate crystals generally form when you have
high levels of uric acid in your blood. Generally, the body produces uric acid
when it breaks down purines (sub stances that are found naturally in the
body and from the food items consumed). Uric acid gets dissolved in your
blood and passes through your kidneys into your urine. But when your body
produces too much uric acid or your kidneys excrete too little uric acid, these
can build up, forming sharp, needle like urate crystals in a joint or
surrounding tissue causing pain, inflammation and swelling.Several potential
factors increase the risks of suffering the condition and these include – age
and sex, obesity, lifestyle choices and diet, chronic lead exposure, family

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history of gout, usage of certain medications and chronic medical conditions
(hypertension, diabetes, metabolic syndrome, and heart and kidney
disease). The estimated prevalence of gout is more among men than
women. The predominant age range of gout is 30 -60 years.
What are the Different Types of Gout?
There are different types of gout, each of which passes through different
stages and these include –
 Acute gout – This type occurs when the urate crystals deposited in
your joint causes sudden, acute pain and inflammation. The sudden
attack is called “flare” that will generally subside within 3-20 days.
 Pseudo gout – Pseudo gout occurs when the joints are irritated by
calcium phosphate crystals rather than urate crystals.
 Asymptomatic hyperuricemia – During this stage, people tend to
experience elevated uric acid levels without outward symptoms.
 Chronic tophaceous gout – One of the most debilitating types,
chronic tophaceous gout occurs when nodular masses of uric acid
crystals (tophi) get deposited in different soft tissue areas of the body.
 Interval or intercritical gout– This stage is the period in between
attacks of acute gout. Subsequent flares may not occur for months or
years, though if not treated, over time, they can last longer and occur
more frequently.
Diagnosing and Treating the Symptoms of Gout
In most cases, the signs and symptoms of gout always occur suddenly
without any warning, and often in the middle of the night. Symptoms usually
start with intense joint pain (affecting the large joint of your big toe) that
later subsides into lingering discomfort, inflammation, and redness. As the
condition progresses, patients may experience limited range of motion

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wherein they may not be able to move their joints normally. In some cases,
the condition can progress into several complicated conditions like kidney
stones. In addition, people may also experience regular recurrences causing
gradual damage to the joints and surrounding tissues.
Diagnosing gout can often be tricky as the signs and symptoms of the
condition may be quite similar to certain rheumatology conditions and other
diseases. Analysis can be made based on a detaile d review of symptoms,
past medical history andphysical examination. Physicians will diagnose the
condition based on the description of the type and intensity of joint pain,
recurrence of pain, and swelling and redness in the joint area. Physicians
may conduct joint fluid test to examine the amount of urate crystals in the
joints. Blood tests may be conducted to measure the levels of uric acid and
creatinine in the blood. Imaging tests like - Joint X-rays, Ultrasound and
Dual energy CT scan will be performe d to identify the causes of joint
inflammation and detect the amount of urate crystals in a joint.
Treatment for this joint inflammatory condition will begin with medications.
Gout medications help treat acute attacks and prevent future attacks. It can
also reduce the patient’s risk of complications from gout, such as the
development of tophi from urate crystal deposits. Medications used to treat
acute gout attacks include – Non-steroidal anti-inflammatory drugs
(NSAIDs) such as - Ibuprofen (Advil, Motrin IB, others), Naproxen sodium
(Aleve), Indomethacin (Indocin) and Celecoxib (Celebrex), Colchicine and
Corticosteroids. Medications to reduce the body’s production of uric acid,
such as allopurinol and probenecid may also be prescribed. Along with
medications, physicians may ask patients to incorporate key lifestyle
changes like – moderating their diet, reducing the alcohol consumption,
losing body weight and quitting the habit of smoking – as these changes will
help them to manage symptoms in a better manner and reduce their risk of
future gout attacks.

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People with gout should take precautions to avoid low-carbohydrate diets.
Low intake of carbohydrate means the body is unable to burn fat stores
properly, leading to the release of substances called “ketones” into the
bloodstream. The increase in ketones can result in a condition called
“ketosis” that can increase the level of uric acid in the blood. Patients also
need to avoid many foods that are high in purines, to ensure that the levels
of uric acid in the blood do not get too high. Physicians must make sure that
they document the diagnostic and treatment procedures using the correct
medical codes.
The diagnostic procedures and other treatment modalities performed by
physicians must be carefully documented using the correct medical codes.
Medical billing and coding outsourcing services offered by reputable
medical billing and coding companies can help physicians use the correct
medical codes for their billing purposes.
ICD-10 Codes for Gout
 M10 - Gout
 M10.0 - Idiopathic gout
 M10.01 - Idiopathic gout, shoulder
 M10.02 - Idiopathic gout, elbow
 M10.03 - Idiopathic gout, wrist
 M10.04 - Idiopathic gout, hand
 M10.05 - Idiopathic gout, hip
 M10.06 - Idiopathic gout, knee
 M10.07 - Idiopathic gout, ankle and foot
 M10.08 -Idiopathic gout, vertebrae
 M10.09 - Idiopathic gout, multiple sites
 M10.1 - Lead-induced gout
 M10.10 -Lead-induced gout, unspecified site

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 M10.11 - Lead-induced gout, shoulder
 M10.12 - Lead-induced gout, elbow
 M10.13 - Lead-induced gout, wrist
 M10.14 - Lead-induced gout, hand
 M10.15 - Lead-induced gout, hip
 M10.16 - Lead-induced gout, knee
 M10.17 - Lead-induced gout, ankle and foot
 M10.18 -Lead-induced gout, vertebrae
 M10.19 -Lead-induced gout, multiple sites
 M10.2 - Drug-induced gout
 M10.20 -Drug-induced gout, unspecified site
 M10.21 - Drug-induced gout, shoulder
 M10.22 - Drug-induced gout, elbow
 M10.23 - Drug-induced gout, wrist
 M10.24 - Drug-induced gout, hand
 M10.25 - Drug-induced gout, hip
 M10.26 - Drug-induced gout, knee
 M10.27 - Drug-induced gout, ankle and foot
 M10.28 -Drug-induced gout, vertebrae
 M10.29 -Drug-induced gout, multiple sites
 M10.3 - Gout due to renal impairment
 M10.30 -Gout due to renal impairment, unspecified site
 M10.31 - Gout due to renal impairment, shoulder
 M10.32 - Gout due to renal impairment, elbow
 M10.33 - Gout due to renal impairment, wrist
 M10.34 - Gout due to renal impairment, hand
 M10.35 - Gout due to renal impairment, hip
 M10.36 - Gout due to renal impairment, knee
 M10.37 - Gout due to renal impairment, ankle and foot

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 M10.38 -Gout due to renal impairment, vertebrae
 M10.39 -Gout due to renal impairment, multiple sites
 M10.4 - Other secondary gout
 M10.40 -Other secondary gout, unspecified site
 M10.41 - Other secondary gout, shoulder
 M10.42 - Other secondary gout, elbow
 M10.43 - Other secondary gout, wrist
 M10.44 - Other secondary gout, hand
 M10.45 Other secondary gout, hip
 M10.46 - Other secondary gout, knee
 M10.47- Other secondary gout, ankle and foot
 M10.48 -Other secondary gout, vertebrae
 M10.49 -Other secondary gout, multiple sites
 M10.9 - Gout, unspecified
Coping with gout can be difficult. However, a person can take adequate
preventive steps to stop flare-up of symptoms or prevent them from
developing complications. Preventive steps include – maintaining a desirable
body weight, consuming a healthy diet, avoiding alcohol consumption and
increasingthe fluid intake (at least 2-4 liters of water every day).
Billing and coding for gout can be complex, as there are several code
categories for this condition. By outsourcing these tasks to an established
rheumatology medical billing and coding company that offers the
services of AAPC-certified coding specialists, rheumatology practices can
ensure correct and timely medical billing and claims submission.