ICD-10 Codes for Documenting the Chronic Symptoms of Gout

ICD-10 Codes for Documenting the Chronic Symptoms of Gout

Gout causes severe pain, swelling and stiffness in the joints. This article details the symptoms, causes and treatment options along with the ICD-10 codes.

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According to recent reports (2019 statistics), Gout affects about 8.3 million people in the United States. Regarded as a complex form of inflammatory arthritis that can affect anyone, Gout is characterized by sudden and severe attacks of pain, swelling, tenderness and redness in the joints. Sudden and intense gout attacks – often first felt at the base of the big toe, can make it feel like your foot is on fire. It can also be felt in the ankles, knees, heels, wrists, fingers and elbows. Gout attacks occur suddenly and keep returning over time, slowly harming tissues in the region of the inflammation. Initially, these attacks get better quickly within days. Later, attacks occur more often and last for more time. Chronic gout is treated using medications that lower the uric acid level in the body. If left untreated, the rheumatology condition can cause irreversible joint damage, kidney problems, and tophi (a deposit of crystalline uric acid at the surface of joints or cartilage). Managing this condition can be quite challenging as there are different stages through which the condition progresses and these are considered as the different types of gout. As physicians focus on their patients, outsourced medical billing and coding services can ensure accurate and proper reporting of services for appropriate reimbursement.

Gout occurs when urate crystals gets accumulated in your joint causing severe pain and inflammation. Urate crystals generally form when you have high levels of uric acid in your blood. Generally, the body produces uric acid when it breaks down purines (substances that are found naturally in the body and from the food items consumed). Uric acid gets dissolved in your blood and passes through your kidneys into your urine. But when your body produces too much uric acid or your kidneys excrete too little uric acid, these can build up, forming sharp, needle like urate crystals in a joint or surrounding tissue causing pain, inflammation and swelling.Several potential factors increase the risks of suffering the condition and these include – age and sex, obesity, lifestyle choices and diet, chronic lead exposure, family www.outsourcestrategies.com

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history of gout, usage of certain medications and chronic medical conditions (hypertension,

diabetes,

metabolic

syndrome,

and

heart

and

kidney

disease). The estimated prevalence of gout is more among men than women. The predominant age range of gout is 30-60 years.

What are the Different Types of Gout?

There are different types of gout, each of which passes through different stages and these include – 

Acute gout – This type occurs when the urate crystals deposited in your joint causes sudden, acute pain and inflammation. The sudden attack is called “flare” that will generally subside within 3-20 days.



Pseudo gout – Pseudo gout occurs when the joints are irritated by calcium phosphate crystals rather than urate crystals.



Asymptomatic hyperuricemia – During this stage, people tend to experience elevated uric acid levels without outward symptoms.



Chronic tophaceous gout – One of the most debilitating types, chronic tophaceous gout occurs when nodular masses of uric acid crystals (tophi) get deposited in different soft tissue areas of the body.



Interval or intercritical gout– This stage is the period in between attacks of acute gout. Subsequent flares may not occur for months or years, though if not treated, over time, they can last longer and occur more frequently.

Diagnosing and Treating the Symptoms of Gout In most cases, the signs and symptoms of gout always occur suddenly without any warning, and often in the middle of the night. Symptoms usually start with intense joint pain (affecting the large joint of your big toe) that later subsides into lingering discomfort, inflammation, and redness. As the condition progresses, patients may experience limited range of motion www.outsourcestrategies.com

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wherein they may not be able to move their joints normally. In some cases, the condition can progress into several complicated conditions like kidney stones. In addition, people may also experience regular recurrences causing gradual damage to the joints and surrounding tissues.

Diagnosing gout can often be tricky as the signs and symptoms of the condition may be quite similar to certain rheumatology conditions and other diseases. Analysis can be made based on a detailed review of symptoms, past medical history andphysical examination. Physicians will diagnose the condition based on the description of the type and intensity of joint pain, recurrence of pain, and swelling and redness in the joint area. Physicians may conduct joint fluid test to examine the amount of urate crystals in the joints. Blood tests may be conducted to measure the levels of uric acid and creatinine in the blood. Imaging tests like - Joint X-rays, Ultrasound and Dual energy CT scan will be performed to identify the causes of joint inflammation and detect the amount of urate crystals in a joint.

Treatment for this joint inflammatory condition will begin with medications.

Gout medications help treat acute attacks and prevent future attacks. It can also reduce the patient’s risk of complications from gout, such as the development of tophi from urate crystal deposits. Medications used to treat acute

gout

attacks

include

–

Non-steroidal

anti-inflammatory

drugs

(NSAIDs) such as - Ibuprofen (Advil, Motrin IB, others), Naproxen sodium (Aleve), Indomethacin (Indocin) and Celecoxib (Celebrex), Colchicine and Corticosteroids. Medications to reduce the body’s production of uric acid, such as allopurinol and probenecid may also be prescribed. Along with medications, physicians may ask patients to incorporate key lifestyle changes like – moderating their diet, reducing the alcohol consumption, losing body weight and quitting the habit of smoking – as these changes will help them to manage symptoms in a better manner and reduce their risk of future gout attacks. www.outsourcestrategies.com

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People with gout should take precautions to avoid low-carbohydrate diets.

Low intake of carbohydrate means the body is unable to burn fat stores properly, leading to the release of substances called “ketones” into the bloodstream. The increase in ketones can result in a condition called “ketosis” that can increase the level of uric acid in the blood. Patients also need to avoid many foods that are high in purines, to ensure that the levels of uric acid in the blood do not get too high. Physicians must make sure that they document the diagnostic and treatment procedures using the correct medical codes.

The diagnostic procedures and other treatment modalities performed by physicians must be carefully documented using the correct medical codes.

Medical billing and coding outsourcing services offered by reputable medical billing and coding companies can help physicians use the correct medical codes for their billing purposes.

ICD-10 Codes for Gout 

M10 - Gout



M10.0 - Idiopathic gout  M10.01 - Idiopathic gout, shoulder  M10.02 - Idiopathic gout, elbow  M10.03 - Idiopathic gout, wrist  M10.04 - Idiopathic gout, hand  M10.05 - Idiopathic gout, hip  M10.06 - Idiopathic gout, knee  M10.07 - Idiopathic gout, ankle and foot  M10.08 -Idiopathic gout, vertebrae  M10.09 - Idiopathic gout, multiple sites



M10.1 - Lead-induced gout  M10.10 -Lead-induced gout, unspecified site

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 M10.11 - Lead-induced gout, shoulder  M10.12 - Lead-induced gout, elbow  M10.13 - Lead-induced gout, wrist  M10.14 - Lead-induced gout, hand  M10.15 - Lead-induced gout, hip  M10.16 - Lead-induced gout, knee  M10.17 - Lead-induced gout, ankle and foot  M10.18 -Lead-induced gout, vertebrae  M10.19 -Lead-induced gout, multiple sites 

M10.2 - Drug-induced gout  M10.20 -Drug-induced gout, unspecified site  M10.21 - Drug-induced gout, shoulder  M10.22 - Drug-induced gout, elbow  M10.23 - Drug-induced gout, wrist  M10.24 - Drug-induced gout, hand  M10.25 - Drug-induced gout, hip  M10.26 - Drug-induced gout, knee  M10.27 - Drug-induced gout, ankle and foot  M10.28 -Drug-induced gout, vertebrae  M10.29 -Drug-induced gout, multiple sites



M10.3 - Gout due to renal impairment  M10.30 -Gout due to renal impairment, unspecified site  M10.31 - Gout due to renal impairment, shoulder  M10.32 - Gout due to renal impairment, elbow  M10.33 - Gout due to renal impairment, wrist  M10.34 - Gout due to renal impairment, hand  M10.35 - Gout due to renal impairment, hip  M10.36 - Gout due to renal impairment, knee  M10.37 - Gout due to renal impairment, ankle and foot

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 M10.38 -Gout due to renal impairment, vertebrae  M10.39 -Gout due to renal impairment, multiple sites 

M10.4 - Other secondary gout  M10.40 -Other secondary gout, unspecified site  M10.41 - Other secondary gout, shoulder  M10.42 - Other secondary gout, elbow  M10.43 - Other secondary gout, wrist  M10.44 - Other secondary gout, hand  M10.45 Other secondary gout, hip  M10.46 - Other secondary gout, knee  M10.47- Other secondary gout, ankle and foot  M10.48 -Other secondary gout, vertebrae  M10.49 -Other secondary gout, multiple sites



M10.9 - Gout, unspecified

Coping with gout can be difficult. However, a person can take adequate preventive steps to stop flare-up of symptoms or prevent them from developing complications. Preventive steps include – maintaining a desirable body weight, consuming a healthy diet, avoiding alcohol consumption and increasingthe fluid intake (at least 2-4 liters of water every day).

Billing and coding for gout can be complex, as there are several code categories for this condition. By outsourcing these tasks to an established rheumatology medical billing and coding company that offers the services of AAPC-certified coding specialists, rheumatology practices can ensure correct and timely medical billing and claims submission.

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