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M1A.4111 vs M1A.4191

M1A.4111 (Other secondary chronic gout, right shoulder, with tophus (tophi)) compared with M1A.4191 (Other secondary chronic gout, unspecified shoulder, with tophus (tophi)), from the official CMS tabular data. M1A.4111 and M1A.4191 code the same condition on opposite sides.

Relationship

Review

Laterality relationship

M1A.4111
Right
Other secondary chronic gout, right shoulder, with tophus (tophi)
M1A.4191
Unspecified
Other secondary chronic gout, unspecified shoulder, with tophus (tophi)

Same condition; these differ only in which side is documented.

These codes share a category and title and differ only in the side affected. The documentation decides which applies, and a bilateral code is reported only where the code set provides one.

Source: ICD-10-CM tabular list (laterality variant derived from the code title)

Can these codes be reported together?

Same condition, opposite side. M1A.4111 and M1A.4191 name the same condition on opposite sides of the body.

Same category and title, differing only in which side is affected — the documentation decides which one applies, and a bilateral code is reported only where the code set provides one.

Side by side

M1A.4111Other secondary chronic gout, right shoulder, with tophus (tophi)M1A.4191Other secondary chronic gout, unspecified shoulder, with tophus (tophi)
Billing statusBillableBillable
ClassificationM00-M99 — Diseases of the Musculoskeletal System and Connective Tissue (M00-M99)M00-M99 — Diseases of the Musculoskeletal System and Connective Tissue (M00-M99)
DefinitionOther secondary chronic gout, right shoulder, with tophus (tophi) is a billable ICD-10-CM diagnosis code (M1A.4111).Other secondary chronic gout, unspecified shoulder, with tophus (tophi) is a billable ICD-10-CM diagnosis code (M1A.4191).
7th characterThe appropriate 7th character is to be added to each code from category M1AThe appropriate 7th character is to be added to each code from category M1A
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
associated condition
associated condition

Derived from the official CMS ICD-10-CM tabular data (FY2026). Not billing advice; verify sequencing rules for the encounter. All data sources