ICD-10 Coding for Arthritis Gout(M10.072, M1A.0720)
Complete ICD-10-CM coding and documentation guide for Arthritis Gout. Includes clinical validation requirements, documentation requirements, and coding pitfalls.
Also known as:
Related ICD-10 Code Ranges
Complete code families applicable to Arthritis Gout
M10-M19Primary Range
Arthropathies
This range includes codes for gout and other arthropathies, with specific codes for acute and chronic gout.
Code Comparison: When to Use Each Code
Compare key differences between these codes to ensure accurate selection
| Code | Description | When to Use | Key Documentation |
|---|---|---|---|
| M10.072 | Acute gout, left ankle and foot | Use this code for acute gout flares in the left ankle and foot. |
|
| M1A.0720 | Chronic gout, left ankle and foot | Use this code for chronic gout conditions with tophi or recurrent flares. |
|
Clinical Decision Support
Always review the patient's clinical documentation thoroughly. When in doubt, choose the more specific code and ensure documentation supports it.
Key Information: ICD-10 code for acute gout
Essential facts and insights about Arthritis Gout
Primary ICD-10-CM Codes for arthritis gout
Decision Criteria
clinical Criteria
- Acute presentation with joint swelling and pain
Applicable To
- Acute gouty arthritis of left ankle
Excludes
- Chronic gout (M1A.-)
Clinical Validation Requirements
- Presence of monosodium urate crystals in synovial fluid
- Acute onset of joint pain and swelling
Code-Specific Risks
- Incorrectly coding chronic gout during an acute flare
Coding Notes
- Ensure to document the acute nature and specific joint affected.
M1A.0720 - Chronic gout, left ankle and foot
Use this code for chronic gout conditions with tophi or recurrent flares.
Applicable To
- Chronic tophaceous gout of left ankle
Excludes
- Acute gout (M10.-)
Clinical Validation Requirements
- Radiographic evidence of tophi
- Recurrent episodes of joint pain
Coding Notes
Document the presence of tophi and chronic symptoms.
Ancillary Codes
Additional codes that should be used in conjunction with the main diagnosis codes when applicable.
Differential Codes
Alternative codes to consider when ruling out similar conditions to the primary diagnosis.
Documentation & Coding Risks
Avoid these common documentation and coding issues when documenting Arthritis Gout to ensure proper reimbursement, maintain compliance, and reduce audit risk. These guidelines are particularly important when using ICD-10 code M10.072.
Impact
Clinical: Leads to inappropriate treatment plans., Regulatory: Non-compliance with ICD-10 specificity requirements., Financial: Potential claim rejections or audits.
Mitigation Strategy
Always specify laterality and joint in documentation., Use templates to ensure completeness.
Impact
Reimbursement: Incorrect coding can lead to claim denials., Compliance: Violates Excludes 1 note in ICD-10., Data Quality: Leads to inaccurate clinical data.
Mitigation Strategy
Use only the acute code during flares.
Impact
Coding both acute and chronic gout together can trigger audits.
Mitigation Strategy
Educate staff on Excludes 1 notes and proper code selection.
Documentation errors, coding pitfalls, and audit risks are interconnected aspects of medical coding and billing. Addressing all three areas helps ensure accurate coding, optimal reimbursement, and regulatory compliance.
Frequently Asked Questions
Common questions about ICD-10 coding for Arthritis Gout, with expert answers to help guide accurate code selection and documentation.
Documentation Templates for Arthritis Gout
Use these documentation templates to ensure complete and accurate documentation for Arthritis Gout. These templates include all required elements for proper coding and billing.
Acute gout flare in the emergency department
Specialty: Emergency MedicineRequired Elements
- History of present illness
- Physical examination findings
- Laboratory results
- Imaging studies
Example Documentation
Examples: Poor vs. Good Documentation
Poor Documentation Example
Good Documentation Example
Explanation
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