2026 ICD-10-CM Diagnosis Code M1A.08X0Idiopathic chronic gout, vertebrae, without tophus (tophi)
ICD-10-CM Codes›M00–M99›M05-M14›M1A
- Billable — Valid for Submission
- 7th Character 0 — Without Tophus
- Chronic Condition
M1A.08X0 is a billable ICD-10-CM diagnosis code for idiopathic chronic gout, vertebrae, without tophus (tophi). The 7th character 0 reports chronic gout without tophus formation. It is valid on HIPAA claims for fiscal year 2026 (October 1, 2025 through September 30, 2026) and groups to MS-DRG 553 through 554. Coders also document this condition as chronic gouty arthritis. In AHRQ's Clinical Classifications Software (CCSR), this diagnosis falls under Gout.
Code Identity
Code Classification
Approximate SynonymsGuidance
Alternate terms and clinical phrases that map to this code.
- Chronic gouty arthritis
- Chronic primary gouty arthritis
- Primary chronic gout without tophus
- Primary chronic gout without tophus of vertebra
Clinical ClassificationClinical
AHRQ’s CCSR groups this code into broader clinical categories.
Patient EducationClinical
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.
The full article covers:
- What is gout?
- What causes gout?
- Who is more likely to develop gout?
- What are the symptoms of gout?
- How is gout diagnosed?
- What are the treatments for gout?
Read the full article at MedlinePlus
Courtesy of MedlinePlus, a service of the U.S. National Library of Medicine.
Convert M1A.08X0 to ICD-9-CMHistory
The closest ICD-9-CM equivalents under the General Equivalence Mappings.
Code HistoryHistory
Questions About M1A.08X0Overview
Is M1A.08X0 (Idiopathic chronic gout, vertebrae) a billable code?
Yes. This is a billable ICD-10-CM code, specific enough to report idiopathic chronic gout, vertebrae, without tophus (tophi) on HIPAA-covered claims from October 1, 2025 through September 30, 2026.
What does the 7th character 0 in M1A.08X0 mean?
The final character 0 reports chronic gout without tophus formation, in this case involving the idiopathic chronic gout, vertebrae.
What MS-DRG does M1A.08X0 group to?
When idiopathic chronic gout, vertebrae, without tophus (tophi) is the principal diagnosis on an inpatient stay, it groups to MS-DRG 553, 554, with relative weights from 0.8301 to 1.2963 depending on complications. Higher weights mean higher Medicare reimbursement.
What is the ICD-9 equivalent of M1A.08X0?
Under the General Equivalence Mappings, idiopathic chronic gout, vertebrae, without tophus (tophi) converts to ICD-9-CM 274.02 (chr gouty atrph wo tophi). The mapping is approximate, so confirm the match fits the documentation.
Footnotes
[1] Chronic - a chronic condition code indicates a condition lasting 12 months or longer and its effect on the patient based on one or both of the following criteria:
- The condition results in the need for ongoing intervention with medical products,treatment, services, and special equipment
- The condition places limitations on self-care, independent living, and social interactions.
