2025 ICD-10-CM Diagnosis Code M1A
Chronic gout
- ICD-10-CM Code:
- M1A
- ICD-10 Code for:
- Chronic gout
- Is Billable?
- Not Valid for Submission
- Code Navigator:
M1A is a non-specific and non-billable diagnosis code code, consider using a code with a higher level of specificity for a diagnosis of chronic gout. The code is not specific and is NOT valid for the year 2025 for the submission of HIPAA-covered transactions. Category or Header define the heading of a category of codes that may be further subdivided by the use of 4th, 5th, 6th or 7th characters.
Specific Coding Applicable to Chronic gout
Non-specific codes like M1A require more digits to indicate the appropriate level of specificity. Consider using any of the following ICD-10-CM codes with a higher level of specificity when coding for chronic gout:
M1A.0 for Idiopathic chronic gout - NON-BILLABLE CODE
M1A.00 for Idiopathic chronic gout, unspecified site - NON-BILLABLE CODE
M1A.01 for Idiopathic chronic gout, shoulder - NON-BILLABLE CODE
M1A.02 for Idiopathic chronic gout, elbow - NON-BILLABLE CODE
M1A.03 for Idiopathic chronic gout, wrist - NON-BILLABLE CODE
M1A.04 for Idiopathic chronic gout, hand - NON-BILLABLE CODE
M1A.05 for Idiopathic chronic gout, hip - NON-BILLABLE CODE
M1A.06 for Idiopathic chronic gout, knee - NON-BILLABLE CODE
M1A.07 for Idiopathic chronic gout, ankle and foot - NON-BILLABLE CODE
M1A.08 for Idiopathic chronic gout, vertebrae - NON-BILLABLE CODE
M1A.09 for Idiopathic chronic gout, multiple sites - NON-BILLABLE CODE
M1A.1 for Lead-induced chronic gout - NON-BILLABLE CODE
M1A.10 for Lead-induced chronic gout, unspecified site - NON-BILLABLE CODE
M1A.11 for Lead-induced chronic gout, shoulder - NON-BILLABLE CODE
M1A.12 for Lead-induced chronic gout, elbow - NON-BILLABLE CODE
M1A.13 for Lead-induced chronic gout, wrist - NON-BILLABLE CODE
M1A.14 for Lead-induced chronic gout, hand - NON-BILLABLE CODE
M1A.15 for Lead-induced chronic gout, hip - NON-BILLABLE CODE
M1A.16 for Lead-induced chronic gout, knee - NON-BILLABLE CODE
M1A.17 for Lead-induced chronic gout, ankle and foot - NON-BILLABLE CODE
M1A.18 for Lead-induced chronic gout, vertebrae - NON-BILLABLE CODE
M1A.19 for Lead-induced chronic gout, multiple sites - NON-BILLABLE CODE
M1A.2 for Drug-induced chronic gout - NON-BILLABLE CODE
M1A.20 for Drug-induced chronic gout, unspecified site - NON-BILLABLE CODE
M1A.21 for Drug-induced chronic gout, shoulder - NON-BILLABLE CODE
M1A.22 for Drug-induced chronic gout, elbow - NON-BILLABLE CODE
M1A.23 for Drug-induced chronic gout, wrist - NON-BILLABLE CODE
M1A.24 for Drug-induced chronic gout, hand - NON-BILLABLE CODE
M1A.25 for Drug-induced chronic gout, hip - NON-BILLABLE CODE
M1A.26 for Drug-induced chronic gout, knee - NON-BILLABLE CODE
M1A.27 for Drug-induced chronic gout, ankle and foot - NON-BILLABLE CODE
M1A.28 for Drug-induced chronic gout, vertebrae - NON-BILLABLE CODE
M1A.29 for Drug-induced chronic gout, multiple sites - NON-BILLABLE CODE
M1A.3 for Chronic gout due to renal impairment - NON-BILLABLE CODE
M1A.30 for Chronic gout due to renal impairment, unspecified site - NON-BILLABLE CODE
M1A.31 for Chronic gout due to renal impairment, shoulder - NON-BILLABLE CODE
M1A.32 for Chronic gout due to renal impairment, elbow - NON-BILLABLE CODE
M1A.33 for Chronic gout due to renal impairment, wrist - NON-BILLABLE CODE
M1A.34 for Chronic gout due to renal impairment, hand - NON-BILLABLE CODE
M1A.35 for Chronic gout due to renal impairment, hip - NON-BILLABLE CODE
M1A.36 for Chronic gout due to renal impairment, knee - NON-BILLABLE CODE
M1A.37 for Chronic gout due to renal impairment, ankle and foot - NON-BILLABLE CODE
M1A.38 for Chronic gout due to renal impairment, vertebrae - NON-BILLABLE CODE
M1A.39 for Chronic gout due to renal impairment, multiple sites - NON-BILLABLE CODE
M1A.4 for Other secondary chronic gout - NON-BILLABLE CODE
M1A.40 for Other secondary chronic gout, unspecified site - NON-BILLABLE CODE
M1A.41 for Other secondary chronic gout, shoulder - NON-BILLABLE CODE
M1A.42 for Other secondary chronic gout, elbow - NON-BILLABLE CODE
M1A.43 for Other secondary chronic gout, wrist - NON-BILLABLE CODE
M1A.44 for Other secondary chronic gout, hand - NON-BILLABLE CODE
M1A.45 for Other secondary chronic gout, hip - NON-BILLABLE CODE
M1A.46 for Other secondary chronic gout, knee - NON-BILLABLE CODE
M1A.47 for Other secondary chronic gout, ankle and foot - NON-BILLABLE CODE
M1A.48 for Other secondary chronic gout, vertebrae - NON-BILLABLE CODE
M1A.49 for Other secondary chronic gout, multiple sites - NON-BILLABLE CODE
M1A.9 for Chronic gout, unspecified - NON-BILLABLE CODE
Tabular List of Diseases and Injuries
The following annotation back-references are applicable to this diagnosis code. The Tabular List of Diseases and Injuries is a list of ICD-10-CM codes, organized "head to toe" into chapters and sections with coding notes and guidance for inclusions, exclusions, descriptions and more.
Use Additional Code
Use Additional CodeThe “use additional code” indicates that a secondary code could be used to further specify the patient’s condition. This note is not mandatory and is only used if enough information is available to assign an additional code.
- code to identify:
- Autonomic neuropathy in diseases classified elsewhere G99.0
- Calculus of urinary tract in diseases classified elsewhere N22
- Cardiomyopathy in diseases classified elsewhere I43
- Disorders of external ear in diseases classified elsewhere H61.1 H62.8
- Disorders of iris and ciliary body in diseases classified elsewhere H22
- Glomerular disorders in diseases classified elsewhere N08
Type 1 Excludes
Type 1 ExcludesA type 1 excludes note is a pure excludes note. It means "NOT CODED HERE!" An Excludes1 note indicates that the code excluded should never be used at the same time as the code above the Excludes1 note. An Excludes1 is used when two conditions cannot occur together, such as a congenital form versus an acquired form of the same condition.
- gout NOS M10
Type 2 Excludes
Type 2 ExcludesA type 2 excludes note represents "Not included here". An excludes2 note indicates that the condition excluded is not part of the condition represented by the code, but a patient may have both conditions at the same time. When an Excludes2 note appears under a code, it is acceptable to use both the code and the excluded code together, when appropriate.
- acute gout M10
7th Character Note
7th Character NoteCertain ICD-10-CM categories have applicable 7th characters. The applicable 7th character is required for all codes within the category, or as the notes in the Tabular List instruct. The 7th character must always be the 7th character in the data field. If a code that requires a 7th character is not 6 characters, a placeholder X must be used to fill in the empty characters.
- The appropriate 7th character is to be added to each code from category M1A
7th Character
7th CharacterIndicates that a seventh character is to be assigned to codes in a subcategory.
- 0 - without tophus (tophi)
- 1 - with tophus (tophi)
Patient Education
Gout
What is gout?
Gout is a common type of inflammatory arthritis. It causes pain, swelling, and redness in one or more joints. It usually happens as a flare, which can last for a week or two and then gets better. The flares often begin in your big toe or a lower limb.
What causes gout?
Gout happens when too much uric acid (urate) builds up in your body over a long time. Uric acid is a waste product your body makes when it breaks down purines. Purines are substances that are in your body's tissues and in many foods.
When your body breaks down old cells or digests foods that contain purine, most of the uric acid that's made dissolves in your blood. Your kidneys filter the uric acid out of your blood, and it leaves your body in your urine (pee).
However, sometimes your body can make too much uric acid or does not remove enough of it. Then the uric acid levels build up in your body, including in your blood. Having too much uric acid in the blood is called hyperuricemia. It does not cause health problems for everyone. But in some people, uric acid forms needle-like crystals. They can form in your joints, which causes gout. The crystals can also cause kidney stones.
Calcium pyrophosphate arthritis, sometimes called pseudogout, is a related disease. It causes similar symptoms and is sometimes confused with gout. But it is caused by a buildup of calcium phosphate, not uric acid.
Who is more likely to develop gout?
Many people develop gout. You are more likely to get it if you:
- Are male.
- Are older; it usually develops in middle age.
- Have obesity.
- Have certain health conditions, such as:
- Heart failure
- High blood pressure
- Metabolic syndrome
- Chronic kidney disease
- Conditions that cause your cells to break down more quickly, such as psoriasis or some cancers
- Rare genetic conditions that lead to increased uric acid
- Have a family history of gout.
- Have an unhealthy diet and eat foods that are rich in purines, such as red meat, organ meats, certain seafoods.
- Drink alcohol.
- Eat and drink lots of foods and beverages that contain fructose (a type of sugar).
- Take certain medicines, such as diuretics (water pills), low-dose aspirin, and some medicines that weaken your immune system.
- Take high amounts of niacin (vitamin B-3).
What are the symptoms of gout?
Gout usually happens in only one joint at a time. It is often found in the big toe, but can also affect other joints, including your other toes, ankle, and knee.
Gout flares often start suddenly at night, and the symptoms in the affected joint often include:
- Intense pain, which may be bad enough to wake you up
- Swelling
- Redness
- Warmth
The flares typically get better within a week or two. In between flares, you usually don't have symptoms. Some people may have flares often, while others may not have another flare for years. But over time, if left untreated, your flares may happen more often and last longer.
And if gout is untreated over long periods of time, you can develop tophi. Tophi are hard, uric acid deposits under the skin. They start out as painless, but over time, they can become painful. They can also cause bone and soft tissue damage and misshapen joints.
How is gout diagnosed?
To find out if you have gout, your health care provider:
- Will take your medical history, which includes asking about your symptoms.
- Will do a physical exam, including examining the affected joint(s).
- May order various tests, such as:
- A test of a sample of fluid from one of your painful joints. The fluid is examined under a microscope and is checked for uric acid crystals.
- A uric acid blood or urine test.
- An ultrasound or special CT scan to look for uric acid crystal buildup in the affected joint and check for other conditions that may be causing the symptoms.
What are the treatments for gout?
There are effective treatments for gout. Which treatment you get will depend on your symptoms and the cause of your gout. The goals of your treatment will be to:
- Reduce the pain from gout flares, by using medicines such as:
- Nonsteroidal anti-inflammatory drugs (NSAIDs) like ibuprofen.
- Acetaminophen and the anti-inflammatory drug colchicine.
- Oral or injected corticosteroids.
- Prevent future flares, for example by:
- Making lifestyle changes such as losing weight, limiting alcohol, and avoiding foods high in purines. If you are taking medicines that can cause high uric acid in the blood, your provider may suggest stopping or changing those medicines.
- If needed, taking medicines to lower uric acid in the blood.
- Prevent tophi and kidney stones, for example with medicines that lower uric acid in the blood.
With early diagnosis, treatment, and lifestyle changes, gout is one of the most controllable forms of arthritis. Treatment and lifestyle changes may help people avoid gout flares, lessen their symptoms, and sometimes even become gout free.
NIH: National Institute of Arthritis and Musculoskeletal and Skin Diseases
[Learn More in MedlinePlus]
Gout
Gout is a type of arthritis that causes pain and swelling in your joints, usually as flares that last for a week or two, and then go away.[Learn More in MedlinePlus]
Code History
- FY 2024 - No Change, effective from 10/1/2023 through 9/30/2024
- FY 2023 - No Change, effective from 10/1/2022 through 9/30/2023
- FY 2022 - No Change, effective from 10/1/2021 through 9/30/2022
- FY 2021 - No Change, effective from 10/1/2020 through 9/30/2021
- FY 2020 - No Change, effective from 10/1/2019 through 9/30/2020
- FY 2019 - No Change, effective from 10/1/2018 through 9/30/2019
- FY 2018 - No Change, effective from 10/1/2017 through 9/30/2018
- FY 2017 - No Change, effective from 10/1/2016 through 9/30/2017
- FY 2016 - New Code, effective from 10/1/2015 through 9/30/2016. This was the first year ICD-10-CM was implemented into the HIPAA code set.