2026 ICD-10-CM Diagnosis Code M1A.1190Lead-induced chronic gout, unspecified shoulder, without tophus (tophi)
ICD-10-CM Codes›M00–M99›M05-M14›M1A
- Billable — Valid for Submission
- 7th Character 0 — Without Tophus
- Chronic Condition
M1A.1190 is a billable ICD-10-CM diagnosis code for lead-induced chronic gout, unspecified shoulder, 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 917 through 918. In AHRQ's Clinical Classifications Software (CCSR), this diagnosis falls under Gout.
Code Identity
Code Classification
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.1190 to ICD-9-CMHistory
The closest ICD-9-CM equivalents under the General Equivalence Mappings.
Code HistoryHistory
Questions About M1A.1190Overview
Is M1A.1190 (Lead-induced chronic gout, unspecified shoulder) a billable code?
Yes. This is a billable ICD-10-CM code, specific enough to report lead-induced chronic gout, unspecified shoulder, without tophus (tophi) on HIPAA-covered claims from October 1, 2025 through September 30, 2026.
What does the 7th character 0 in M1A.1190 mean?
The final character 0 reports chronic gout without tophus formation, in this case involving the lead-induced chronic gout, unspecified shoulder.
What MS-DRG does M1A.1190 group to?
When lead-induced chronic gout, unspecified shoulder, without tophus (tophi) is the principal diagnosis on an inpatient stay, it groups to MS-DRG 917, 918, with relative weights from 0.8571 to 1.5684 depending on complications. Higher weights mean higher Medicare reimbursement.
What is the ICD-9 equivalent of M1A.1190?
Under the General Equivalence Mappings, lead-induced chronic gout, unspecified shoulder, without tophus (tophi) converts to ICD-9-CM 984.9 (tox eff lead compnd NOS). 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.
