Lead-induced chronic gout, left shoulder, with tophus

This code signifies a chronic inflammatory arthritis affecting the left shoulder, specifically caused by lead exposure. The presence of tophi, which are deposits of uric acid crystals, indicates advanced or long-standing disease. This condition results in pain, swelling, and potential joint damage in the affected shoulder.

Use this code when documentation clearly indicates chronic gout in the left shoulder, explicitly linked to lead toxicity, and confirms the presence of tophi. This diagnosis is typically supported by a history of lead exposure, elevated blood lead levels, elevated serum uric acid, and imaging or clinical findings consistent with tophaceous gout in the left shoulder.

• Ensure documentation specifies "chronic" gout and a direct causal link to "lead" exposure.
• Verify the laterality is "left shoulder" and that "tophi" are present.
• Always sequence a code for the lead poisoning (e.g., T56.0X-) as the primary diagnosis, followed by this code as a secondary diagnosis, to fully capture the etiology.