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

This code signifies a chronic inflammatory arthritis affecting the left wrist, specifically caused by impaired kidney function, and characterized by the presence of urate crystal deposits (tophi). The gout is persistent and directly attributable to the body's inability to properly excrete uric acid due to renal issues.

Apply this code when documentation clearly states chronic gout in the left wrist, explicitly linking its etiology to renal impairment. The presence of visible or palpable tophi in the affected joint should also be documented. This code is appropriate for patients with established chronic kidney disease or other renal conditions leading to hyperuricemia and subsequent gout.

• Ensure documentation specifies "chronic" gout and explicitly links it to "renal impairment."
• Verify the laterality (left wrist) and the presence of "tophi" are clearly stated in the medical record.
• Always code the underlying renal disease first, as it is the etiology for this type of gout.