2027 ICD-10-CM Diagnosis Code M1A.3621Chronic gout due to renal impairment, left knee, with tophus (tophi)
ICD-10-CM Codes›M00–M99›M05-M14›M1A
- Billable — Valid for Submission
- 7th Character 1 — With Tophus (tophi)
- Chronic Condition
M1A.3621 is a billable ICD-10-CM diagnosis code for chronic gout due to renal impairment, left knee, with tophus (tophi). The 7th character 1 means with tophus (tophi). It is valid on HIPAA claims for fiscal year 2027 (October 1, 2026 through September 30, 2027) and groups to MS-DRG 553 through 554. In AHRQ's Clinical Classifications Software (CCSR), this diagnosis falls under Gout.
Code Identity
Code Classification
Instructional NotesGuidance
Instructions from the official ICD-10-CM Tabular List that apply to M1A.3621: its own notes plus those printed at M1A.3, M1A, block M00-M25, and Chapter 13. A note printed at a category, block or chapter applies to every code under it.
Includes
Further defines, or gives examples of, the content of the category.
- Disorders affecting predominantly peripheral (limb) joints
Excludes1
Not coded here: the excluded code is never reported together with this one, unless the two conditions are unrelated.
Excludes2
Not included here: the excluded condition is not part of this code, but a patient may have both, so both codes may be reported.
- arthropathic psoriasis (L40.5-)
- certain conditions originating in the perinatal period (P04-P96)
- certain infectious and parasitic diseases (A00-B99)
- compartment syndrome (traumatic) (T79.A-)
- complications of pregnancy, childbirth and the puerperium (O00-O9A)
- congenital malformations, deformations, and chromosomal abnormalities (Q00-Q99)
- endocrine, nutritional and metabolic diseases (E00-E88)
- injury, poisoning and certain other consequences of external causes (S00-T88)
- neoplasms (C00-D49)
- symptoms, signs and abnormal clinical and laboratory findings, not elsewhere classified (R00-R94)
Code First
The underlying condition named in the note is sequenced before this code.
- associated renal disease
Use Additional Code
Add a second code, after this one, to fully describe the condition.
- 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)
Notes
General instructions on how these codes are used.
- Use an external cause code following the code for the musculoskeletal condition, if applicable, to identify the cause of the musculoskeletal condition
7th Character
Every code in the category takes a 7th character from the listed values, with the placeholder X filling any empty positions before it.
- The appropriate 7th character is to be added to each code from category M1A
- 0without tophus (tophi)
- 1with tophus (tophi) this code
Source: CMS ICD-10-CM Tabular List. How to read instructional notes.
Referenced in Other NotesGuidance
Instructional notes printed at other codes that name M1A.3621, its category, or a range that includes it.
Excludes1 2
These codes carry an Excludes1 note naming M1A.3621: they are not reported together with it, unless the two conditions are unrelated.
Excludes2 2
These codes carry an Excludes2 note naming M1A.3621: its condition is not part of those codes, and both may be reported when the patient has both.
Code First 5
These codes say to code first a condition named in the note, and M1A.3621 is one of the conditions named.
- G99.0 Autonomic neuropathy in diseases classified elsewheregout (M1A.-, M10.-) names M1A.-, which includes this code
- H22 Disorders of iris and ciliary body in diseases classified elsewheregout (M1A.-, M10.-) names M1A.-, which includes this code
- H62.8 Other disorders of external ear in diseases classified elsewheregout (M1A.-, M10.-) names M1A.-, which includes this code
- N08 Glomerular disorders in diseases classified elsewheregout (M1A.-, M10.-) names M1A.-, which includes this code
- N22 Calculus of urinary tract in diseases classified elsewheregout (M1A.-, M10.-) names M1A.-, which includes this code
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.3621 to ICD-9-CMHistory
The closest ICD-9-CM equivalents under the General Equivalence Mappings.
Code HistoryHistory
Questions About M1A.3621Overview
What is the ICD-10 code for chronic gout due to renal impairment, left knee, with tophus (tophi)?
The ICD-10-CM code for chronic gout due to renal impairment, left knee, with tophus (tophi) is M1A.3621 (sometimes written as M1A3621). It is billable on HIPAA-covered claims from October 1, 2026 through September 30, 2027.
Is M1A.3621 (Chronic gout due to renal impairment, left knee) a billable code?
Yes. This is a billable ICD-10-CM code, specific enough to report chronic gout due to renal impairment, left knee, with tophus (tophi) on HIPAA-covered claims from October 1, 2026 through September 30, 2027.
What does the 7th character 1 in M1A.3621 mean?
The final character 1 means with tophus (tophi), in this case for the chronic gout due to renal impairment, left knee. It comes from the 7th character list in the CMS Tabular List for this category.
What MS-DRG does M1A.3621 group to?
When chronic gout due to renal impairment, left knee, with tophus (tophi) is the principal diagnosis on an inpatient stay, it groups to MS-DRG 554, 553, with relative weights from 0.8328 to 1.2492 depending on complications. Higher weights mean higher Medicare reimbursement.
Can M1A.3621 be reported with a code from M10?
Not as a rule. The Excludes1 note at M1A, which applies to M1A.3621, lists "gout NOS (M10.-)". An Excludes1 note means the excluded code is never reported together with this one; the only exception is when the two conditions are unrelated to each other (Official Guidelines, Section I.A.12.a).
