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

This diagnosis code signifies a chronic inflammatory arthritis caused by the deposition of uric acid crystals, specifically in an unspecified wrist joint, and is a direct consequence of impaired kidney function. The presence of tophi, which are visible or palpable nodules of uric acid crystals, further characterizes this condition.

Apply this code when documentation clearly links chronic gout in the wrist to underlying renal impairment, and tophaceous deposits are noted. Supporting documentation would include physician notes detailing chronic gout, evidence of renal dysfunction (e.g., elevated creatinine, eGFR), and physical exam findings or imaging confirming tophi in the wrist.

• Ensure documentation explicitly states the causal link between renal impairment and the gout.
• Do not use this code if the specific wrist (right or left) is documented; instead, select a more specific laterality code.
• This code requires the presence of tophi; if tophi are not documented, a different code for chronic gout due to renal impairment without tophi should be used.