Chronic gout due to renal impairment, right wrist, w tophus

This code signifies a chronic inflammatory arthritis affecting the right wrist, specifically caused by elevated uric acid levels due to impaired kidney function. The presence of tophi, which are deposits of uric acid crystals, further characterizes this condition.

Apply this code when documentation clearly indicates chronic gout in the right wrist, directly attributed to renal insufficiency, and explicitly mentions the presence of tophaceous deposits. This typically occurs in patients with long-standing kidney disease and poorly controlled hyperuricemia.

• Ensure documentation specifies "chronic" gout and a clear causal link to "renal impairment."
• Verify the affected joint is the "right wrist" and that "tophus" or "tophi" are present.
• Do not use this code for acute gout, gout without tophi, or gout due to other etiologies.