Chronic gout due to renal impairment, unsp shldr, w/o toph

This code signifies a persistent inflammatory arthritis caused by elevated uric acid levels, specifically resulting from impaired kidney function, affecting an unspecified shoulder joint. The key characteristic is the absence of urate crystal deposits (tophi) in or around the joint.

Apply this code when documentation confirms a diagnosis of chronic gout directly attributed to renal impairment, with the patient presenting with symptoms in the shoulder. The medical record must explicitly state the absence of tophi and specify the shoulder as the affected joint.

• Ensure documentation clearly links the chronic gout to renal impairment as the etiology.
• Verify the absence of tophi; if present, a different code would be appropriate.
• Confirm the affected joint is the shoulder; laterality (right/left) is unspecified with this particular code.