Chronic gout due to renal impairment, right knee, w/o tophus

This code signifies a persistent inflammatory arthritis affecting the right knee, caused by the accumulation of uric acid crystals due to impaired kidney function. The distinguishing factor is the absence of visible or palpable tophi, which are characteristic uric acid deposits.

Apply this code when documentation clearly indicates chronic gout in the right knee, directly attributed to renal impairment. Supporting documentation should include a diagnosis of chronic gout, a history or current diagnosis of renal dysfunction, and a specific notation that tophi are not present.

• Always code the underlying renal impairment first, as it is the etiology of the gout.
• Ensure the documentation specifies "chronic" gout and the laterality (right knee).
• Differentiate from acute gout or gout with tophi, as these have distinct codes.