2026 ICD-10-CM Diagnosis Code M1A.2211Drug-induced chronic gout, right elbow, with tophus (tophi)

ICD-10-CM Codes›M00–M99›M05-M14›M1A

ICD-10-CM M1A.2211
CMSSource: CMS FY 2026 ICD-10-CM dataset · Effective Oct 1, 2025 – Sep 30, 2026

M1A.2211 is a billable ICD-10-CM diagnosis code for drug-induced chronic gout, right elbow, with tophus (tophi). The 7th character 1 reports chronic gout with tophus formation (tophi). 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. In AHRQ's Clinical Classifications Software (CCSR), this diagnosis falls under Drug induced or toxic related condition and Gout.

Code Identity

ICD-10-CM Code
M1A.2211
Billable Status
Yes — Valid for Submission
Code Describes
Drug-induced chronic gout, right elbow, with tophus (tophi)
Short Description
Drug-induced chronic gout, right elbow, with tophus (tophi)
Same as the full description in the CMS dataset.
Parent Code
M1A.221
Drug-induced chronic gout, right elbow

Code Classification

ChapterM00–M99Diseases of the musculoskeletal system and connective tissue
SectionM05-M14Inflammatory polyarthropathies
CategoryM1AChronic gout
This CodeM1A.2211Drug-induced chronic gout, right elbow, with tophus (tophi)

Clinical ClassificationClinical

AHRQ’s CCSR groups this code into broader clinical categories.

CCSR INJ030
Drug induced or toxic related condition
Default principal diagnosis: inpatient Yes · outpatient Yes
CCSR MUS033
Gout
Default principal diagnosis: inpatient No · outpatient No

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.2211 to ICD-9-CMHistory

The closest ICD-9-CM equivalents under the General Equivalence Mappings.

ICD-9-CM
274.03 Chr gouty atroph w tophi
Approximate The match is approximate rather than exact.

Code HistoryHistory

FY 2016AddedAdded to the ICD-10-CM code setEffective October 1, 2015, the first year of ICD-10-CM.
FY 2017–2025No changes
FY 2026CurrentCurrent code set, no changesEffective October 1, 2025 through September 30, 2026.

Questions About M1A.2211Overview

Is M1A.2211 (Drug-induced chronic gout, right elbow) a billable code?

Yes. This is a billable ICD-10-CM code, specific enough to report drug-induced chronic gout, right elbow, with tophus (tophi) on HIPAA-covered claims from October 1, 2025 through September 30, 2026.

What does the 7th character 1 in M1A.2211 mean?

The final character 1 reports chronic gout with tophus formation (tophi), in this case involving the drug-induced chronic gout, right elbow.

What MS-DRG does M1A.2211 group to?

When drug-induced chronic gout, right elbow, with 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.2211?

Under the General Equivalence Mappings, drug-induced chronic gout, right elbow, with tophus (tophi) converts to ICD-9-CM 274.03 (chr gouty atroph w 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.