M10 vs M1A.19X1
M10 (Gout) compared with M1A.19X1 (Lead-induced chronic gout, multiple sites, with tophus (tophi)), from the official CMS tabular data. Do not report these codes together: the official tabular list marks them Excludes1.
Can these codes be reported together?
Yes, when both are documented. M10 carries an Excludes2 note covering M1A.19X1: “chronic gout (M1A.-)”
Excludes2 marks distinct conditions — both may be reported when both are documented.
No — do not report together. M1A.19X1 carries an Excludes1 note covering M10: “gout NOS (M10.-)”
Sole exception: when the two conditions are documented as unrelated to each other (ICD-10-CM Official Guidelines, Section I.A.12.a).
Yes, when both are documented. M1A.19X1 carries an Excludes2 note covering M10: “acute gout (M10.-)”
Excludes2 marks distinct conditions — both may be reported when both are documented.
Side by side
| M10Gout | M1A.19X1Lead-induced chronic gout, multiple sites, with tophus (tophi) | |
|---|---|---|
| Billing status | Non-billable header | Billable |
| Classification | M00-M99 — Diseases of the Musculoskeletal System and Connective Tissue (M00-M99) | M00-M99 — Diseases of the Musculoskeletal System and Connective Tissue (M00-M99) |
| Definition | Gout is a non-billable ICD-10-CM category code (M10). | Lead-induced chronic gout, multiple sites, with tophus (tophi) is a billable ICD-10-CM diagnosis code (M1A.191). |
| 7th character | — | The appropriate 7th character is to be added to each code from category M1A |
| Includes | Acute gout Gout attack Gout flare Podagra | — |
| Use additional code | code to identify: Autonomic neuropathy in diseases classified elsewhere (G99.0) Calculus of urinary tract in diseases classified elsewhere (N22) | code to identify: Autonomic neuropathy in diseases classified elsewhere (G99.0) Calculus of urinary tract in diseases classified elsewhere (N22) |
| Code first | — | toxic effects of lead and its compounds (T56.0-) |
Derived from the official CMS ICD-10-CM tabular data (FY2026). Not billing advice; verify sequencing rules for the encounter. All data sources