Lead-induced chronic gout, right shoulder, with tophus

This code signifies a chronic inflammatory arthritis affecting the right shoulder, specifically caused by lead exposure. The presence of tophi, which are deposits of uric acid crystals, indicates advanced disease.

Apply this code when documentation clearly states chronic gout in the right shoulder, explicitly linked to lead poisoning, and notes the presence of tophi. This diagnosis requires a confirmed history of lead exposure and clinical findings consistent with chronic gouty arthritis.

• Ensure documentation specifies "chronic" gout and a direct causal link to "lead."
• Verify the affected joint is the "right shoulder" and that "tophus" (or tophi) is present.
• Always code the underlying lead poisoning (e.g., T56.0X1-) as a primary or secondary diagnosis, depending on the encounter's focus.