2025 ICD-10-CM code M10.9
Gout, unspecified. This code is used when the provider doesn't document a specific type of gout.
The medical necessity for using M10.9 is established by the presence of signs, symptoms, and laboratory findings consistent with gout, without further specification of the type of gout.The documentation should support the diagnosis of gout, but not provide enough detail to code a more specific gout diagnosis.
Diagnosis of gout is based on patient history, physical examination, imaging (X-rays), and laboratory tests of blood, urine, and synovial fluid. Treatment may involve lifestyle changes like exercise and dietary modifications to lower purine intake (purines contribute to uric acid levels). Medications such as analgesics, corticosteroids, and NSAIDs can help manage pain and inflammation.
In simple words: Gout is a painful condition where crystals form in your joints due to high levels of uric acid in your blood.This causes sudden swelling, redness, and severe pain, often in your big toe, but it can affect other joints too.This code is used when the doctor doesn't specify what kind of gout it is.
Gout is a form of inflammatory arthritis characterized by recurrent attacks of acute inflammatory arthritis—a red, tender, hot, and swollen joint.Pain typically comes on rapidly in less than 12 hours. The joint at the base of the big toe is most commonly affected, although it may occur in other joints as well. The cause of gout is high levels of uric acid in the blood. The uric acid crystallizes, and the crystals deposit in joints, tendons, and surrounding tissues. This code is used when the provider doesn't specify the type of gout.
Example 1: A 55-year-old male presents with sudden, intense pain and swelling in his right big toe. He reports previous similar episodes.Blood work reveals elevated uric acid levels. The physician diagnoses gout, but does not specify the type, so M10.9 is used., A 60-year-old female experiences pain and inflammation in her left ankle. After examination and testing, she is diagnosed with gout. No further details about the type are documented, so M10.9 is appropriate., A patient with a history of gout presents with pain in their right knee. The physician notes it as a gout flare-up without specifying the type. M10.9 is used for this encounter.
Documentation should include evidence of acute joint inflammation, elevated uric acid levels, patient history, physical exam findings, and results of any imaging or laboratory tests.If there are any associated conditions or causes, these should also be documented.The lack of documentation specifying the type of gout should also be clear.
** For accurate coding, ensure the documentation clearly supports a diagnosis of gout without specifying the type.If a cause for the gout is documented (such as lead or drug-induced gout) a more specific code should be used. If the chronicity is known (chronic vs acute), a more specific code should be used.
- Payment Status: Active
- Specialties:Rheumatology, Primary Care, Internal Medicine, Orthopedics
- Place of Service:Office, Inpatient Hospital, Outpatient Hospital,Emergency Room - Hospital,Urgent Care Facility