2026 ICD-10-CM Diagnosis Code M1A.3191Chronic gout due to renal impairment, unspecified shoulder, with tophus (tophi)

ICD-10-CM Codes›M00–M99›M05-M14›M1A

ICD-10-CM M1A.3191
CMSSource: CMS FY 2026 ICD-10-CM dataset · Effective Oct 1, 2025 – Sep 30, 2026

M1A.3191 is a billable ICD-10-CM diagnosis code for chronic gout due to renal impairment, unspecified shoulder, 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. Coders also document this condition as chronic tophaceous gout of shoulder due to renal impairment. In AHRQ's Clinical Classifications Software (CCSR), this diagnosis falls under Gout.

Code Identity

ICD-10-CM Code
M1A.3191
Billable Status
Yes — Valid for Submission
Code Describes
Chronic gout due to renal impairment, unspecified shoulder, with tophus (tophi)
Short Description
Chronic gout due to renal impairment, unsp shoulder, w toph
Parent Code
M1A.319
Chronic gout due to renal impairment, unspecified shoulder

Code Classification

ChapterM00–M99Diseases of the musculoskeletal system and connective tissue
SectionM05-M14Inflammatory polyarthropathies
CategoryM1AChronic gout
This CodeM1A.3191Chronic gout due to renal impairment, unspecified shoulder, with tophus (tophi)

Approximate SynonymsGuidance

Alternate terms and clinical phrases that map to this code.

  • Chronic tophaceous gout of shoulder due to renal impairment
  • Gout of shoulder due to renal impairment

Clinical ClassificationClinical

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

CCSR MUS033
Gout
Default principal diagnosis: inpatient Yes · outpatient Yes

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.3191 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.3191Overview

Is M1A.3191 (Chronic gout due to renal impairment, unspecified shoulder) a billable code?

Yes. This is a billable ICD-10-CM code, specific enough to report chronic gout due to renal impairment, unspecified shoulder, with tophus (tophi) on HIPAA-covered claims from October 1, 2025 through September 30, 2026.

What does the 7th character 1 in M1A.3191 mean?

The final character 1 reports chronic gout with tophus formation (tophi), in this case involving the chronic gout due to renal impairment, unspecified shoulder.

What MS-DRG does M1A.3191 group to?

When chronic gout due to renal impairment, unspecified shoulder, 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.3191?

Under the General Equivalence Mappings, chronic gout due to renal impairment, unspecified shoulder, 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.