Drug-induced chronic gout, left hand, with tophus (tophi)

This diagnosis code signifies chronic gout that has been induced by medication, specifically affecting the left hand, and presenting with visible or palpable tophi. Tophi are deposits of uric acid crystals that form under the skin, in joints, or other tissues, indicating long-standing, uncontrolled hyperuricemia. The drug-induced nature differentiates this from primary or other secondary forms of gout.

This code is appropriate when documentation clearly states chronic gout of the left hand, explicitly links its etiology to a specific medication, and notes the presence of tophi. Common scenarios include patients on diuretics or certain immunosuppressants developing chronic gout with visible nodular deposits in the joints of their left hand. Physician notes should specify the drug causation and the chronicity of the condition.

• Ensure documentation explicitly states "drug-induced" and identifies the specific drug if possible, though not required for this code.
• Verify the laterality (left hand) and the presence of tophi are clearly documented.
• Do not use this code for acute drug-induced gout or chronic gout without tophi; separate codes exist for those conditions.