Other secondary chronic gout, left shoulder, with tophus

This code signifies a chronic form of gout that has developed as a consequence of another underlying condition, specifically affecting the left shoulder joint. The presence of tophi, which are deposits of uric acid crystals, indicates advanced or long-standing disease. This is distinct from acute gout flares or primary gout.

Use this code when documentation clearly states "secondary chronic gout" involving the left shoulder, and explicitly mentions the presence of tophi. This typically applies to patients with a history of conditions predisposing to hyperuricemia (e.g., renal disease, certain medications) who present with chronic left shoulder pain and confirmed tophaceous deposits.

• Ensure documentation specifies "secondary" gout; otherwise, consider codes for primary chronic gout.
• Verify the laterality (left shoulder) and the presence of tophi are explicitly stated in the physician's notes.
• Always code the underlying condition causing the secondary gout first, if known and documented.