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

This code signifies a chronic inflammatory arthritis affecting the left knee, specifically caused by impaired kidney function, without the presence of urate crystal deposits (tophi). The underlying renal dysfunction leads to hyperuricemia, which in turn precipitates gout attacks in the joint.

Apply this code when documentation clearly states chronic gout in the left knee is attributed to renal impairment, and there is no mention of tophi. This diagnosis is supported by laboratory findings indicating elevated serum uric acid levels and evidence of chronic kidney disease, along with clinical signs and symptoms localized to the left knee.

• Always confirm the laterality (left knee) and the absence of tophi from the physician's documentation.
• Ensure the medical record explicitly links the gout to renal impairment; otherwise, a different etiology code for gout may be more appropriate.
• Sequence this code before any codes for the specific type or stage of chronic kidney disease, as the renal impairment is the underlying cause of the gout.