ICD-10 Coding for Acute Gout(M10.072, M10.041)
Complete ICD-10-CM coding and documentation guide for Acute Gout. Includes clinical validation requirements, documentation requirements, and coding pitfalls.
Also known as:
Related ICD-10 Code Ranges
Complete code families applicable to Acute Gout
Code Comparison: When to Use Each Code
Compare key differences between these codes to ensure accurate selection
| Code | Description | When to Use | Key Documentation |
|---|---|---|---|
| M10.072 | Acute gout, left ankle and foot | Use when there is an acute flare in the left ankle or foot confirmed by synovial fluid analysis. |
|
| M10.041 | Drug-induced gout, right hand | Use when gout is induced by medication and affects the right hand. |
|
Clinical Decision Support
Always review the patient's clinical documentation thoroughly. When in doubt, choose the more specific code and ensure documentation supports it.
Key Information: ICD-10 code for acute gout
Essential facts and insights about Acute Gout
Primary ICD-10-CM Codes for acute gout
Decision Criteria
clinical Criteria
- Presence of acute symptoms and positive synovial fluid analysis
Applicable To
- Podagra
Excludes
- Chronic gout (M1A.-)
Clinical Validation Requirements
- Positive MSU crystals in synovial fluid
- Serum urate levels >6 mg/dL
Code-Specific Risks
- Ensure laterality is documented to avoid unspecified coding.
Coding Notes
- Ensure acute designation and laterality are clearly documented.
M10.041 - Drug-induced gout, right hand
Use when gout is induced by medication and affects the right hand.
Applicable To
- Gout due to medication use
Excludes
- Chronic gout (M1A.-)
Clinical Validation Requirements
- History of drug use known to induce gout
- Acute symptoms in the right hand
Coding Notes
Ensure drug causation is documented.
Ancillary Codes
Additional codes that should be used in conjunction with the main diagnosis codes when applicable.
Differential Codes
Alternative codes to consider when ruling out similar conditions to the primary diagnosis.
Documentation & Coding Risks
Avoid these common documentation and coding issues when documenting Acute Gout to ensure proper reimbursement, maintain compliance, and reduce audit risk. These guidelines are particularly important when using ICD-10 code M10.072.
Impact
Clinical: Inaccurate treatment plans., Regulatory: Non-compliance with ICD-10 requirements., Financial: Potential claim denials.
Mitigation Strategy
Always specify the affected side., Use templates that prompt for laterality.
Impact
Reimbursement: Incorrect coding can lead to claim denials., Compliance: Violates Excludes1 note in ICD-10., Data Quality: Leads to inaccurate clinical data.
Mitigation Strategy
Only code the acute condition when both are present.
Impact
High denial rates for unspecified gout codes.
Mitigation Strategy
Use specific codes with documented laterality and diagnostic confirmation.
Documentation errors, coding pitfalls, and audit risks are interconnected aspects of medical coding and billing. Addressing all three areas helps ensure accurate coding, optimal reimbursement, and regulatory compliance.
Frequently Asked Questions
Common questions about ICD-10 coding for Acute Gout, with expert answers to help guide accurate code selection and documentation.
Documentation Templates for Acute Gout
Use these documentation templates to ensure complete and accurate documentation for Acute Gout. These templates include all required elements for proper coding and billing.
Emergency Department Presentation
Specialty: Emergency MedicineRequired Elements
- Location of pain
- Onset and severity
- Diagnostic tests performed
Example Documentation
Examples: Poor vs. Good Documentation
Poor Documentation Example
Good Documentation Example
Explanation
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