M10.04 ICD-10-CM Code: Idiopathic gout, hand
Billing Status: NO. This is a clinician non-billable / parent hierarchy grouping in the ICD-10-CM system.
Coding at a Glance
- Tabular directives
- 1 Excludes2 · 7 use-additional codes
Coding instructions
Official Tabular Instructional Notes: the inclusion, exclusion and sequencing notes published for M10.04 in the official ICD-10-CM tabular list, quoted as published.
Source: CMS/CDC — ICD-10-CM Tabular ListRelease: FY2026Effective: October 1, 2025
Notes without a marker are published on M10.04 itself; “inherited from” names the category or block whose note applies here.
Excludes2 — Not Included Here
Conditions not covered by this code, but which may be reported alongside it when both are present.
- chronic gout (M1A.-) Compare M10.04 vs M1A →
Source: inherited from M10
Use Additional Code
Supplementary codes the tabular list directs you to add.
- Use additional code to identify:
- Autonomic neuropathy in diseases classified elsewhere (G99.0)
- Calculus of urinary tract in diseases classified elsewhere (N22)
- Cardiomyopathy in diseases classified elsewhere (I43)
- Disorders of external ear in diseases classified elsewhere (H61.1-, H62.8-)
- Disorders of iris and ciliary body in diseases classified elsewhere (H22)
- Glomerular disorders in diseases classified elsewhere (N08)
Source: inherited from M10
Coder workflow for M10.04
MedCoder structured workflow — derived from this code’s own official record
Before you code M10.04
- M10.04 is not reportable as written. Select the more specific code beneath it that the documentation supports. Codes are reported to the highest level of specificity the classification provides (Guidelines I.B.2).
ReviewM10.041, M10.042, M10.049
See the relationships section · Guide: How to choose an ICD-10-CM code →
Choose the right path
- Does the documentation support one of the more specific codes beneath M10.04?
Yes → Select that code and continue the checks below on its own page.
No → M10.04 cannot be reported as written; query for the specificity its subcategory needs.
Consider M10.04. Then work the Use Additional Code note, and confirm the code is valid for the date of service in the Verify section.
Documentation check
- The provider’s diagnostic statement
- Codes are assigned from the provider’s documented diagnosis, not from clinical criteria, test values or a medication list (Guidelines I.A.19).
- Anatomical site
- At the most specific level the record states; a site the classification separates cannot be assumed from a procedure or a measurement.
- The conditions the Use Additional Code note names
- Reported with this code when documented; a conditional instruction (“if applicable”, “if known”) applies only when the record supports it.
Official instructions as workflow
Excludes2 — not part of M10.04(1 note)
Coding workflow: The conditions named in this note are not included in M10.04. When the record documents both, both may be reported; the note is a boundary, not a prohibition.
CompareM1A
See the official tabular notes · Guidelines I.A.12.b
Use Additional Code — after identifying M10.04(7 notes)
Coding workflow: Check whether the documentation supports the additional code(s) the note names, and report them with M10.04 when it does. Where the instruction is conditional (“if applicable”, “if known”), it applies only when the record documents the condition.
ReviewG99.0, N22, I43, H61.1, H62.8, H22
See the official tabular notes · Guidelines I.A.13
Coding decision scenarios
Pattern scenarios for this code’s structure — decision rules, not clinical cases
Documentation: A condition the Use Additional Code note names is documented.
Coding question: Is a second code reported with M10.04?
Path: Review the Use Additional Code note and the code it names.
Reason: The additional code is reported when the record documents the condition; a conditional instruction applies only when its condition is met (Guidelines I.A.13).
Every row is derived from this code’s own record — its title, tabular notes, 7th-character family and same-category siblings — with fixed MedCoder wording; nothing is inferred about a patient. The official notes and guideline text are in the sections each row links to, and they control.
Code Overview
MedCoder summary Summary composed by MedCoder from this code's official ICD-10-CM record. The tabular instructional notes themselves appear verbatim below.
Verify Before Coding
From the code registry, the Medicare Code Editor, and the MS-DRG Definitions Manual. Check it against a full claim in Claim Check.
Relationships & Classification
MedCoder structured relationships — computed from published CMS and AHRQ datasets
Other codes that name M10.04 or its code family, from the CMS ICD-10-CM tabular instructional notes. Tabular-note edges are stored at the code family level that carries each note.
Referenced by 3 Excludes1 notes across 2 chapters: E72 — Other disorders of amino-acid metabolism (via M10.-), E79 — Disorders of purine and pyrimidine metabolism (via M10.-), M1A — Chronic gout (via M10.-).
These codes’ tabular lists mark this diagnosis as mutually exclusive — not reported together unless the conditions are documented as unrelated.
Referenced by 1 Excludes2 note: M1A — Chronic gout (via M10.-).
These codes’ tabular lists name this diagnosis as distinct — both may be reported when both are documented.
Referenced by 6 Code First instructions across 5 chapters: G99.0 — Autonomic neuropathy in diseases classified elsewhere (via M10.-), H22 — Disorders of iris and ciliary body in diseases classified elsewhere (via M10.-), H62.8 — Other disorders of external ear in diseases classified elsewhere (via M10.-), I43 — Cardiomyopathy in diseases classified elsewhere (via M10.0.-), N08 — Glomerular disorders in diseases classified elsewhere (via M10.-), N22 — Calculus of urinary tract in diseases classified elsewhere (via M10.-).
Each of these codes carries a Code First note naming this condition — when that code is reported, THIS code is sequenced first, ahead of it.
Related Codes
Same Index main term, other category
The ICD-10-CM Index to Diseases and Injuries files this code under the main term “Gout, gouty”; these codes share that main term but sit in a different category of the Tabular List.
Contextual Map
Every relationship of M10.04 in one view: hierarchy, official tabular instructions in both directions, clinical classification, risk adjustment, MS-DRG participation, index terms and change history — each edge carrying the CMS source it derives from.
Run M10.04 with these 9 related codes in Claim Check
Hierarchy
- M00-M99 — Chapter 13: Diseases of the Musculoskeletal System and Connective Tissue (M00-M99) (M00-M99)[Hierarchy]— CMS ICD-10-CM tabular structure · icd10cm-fy2026
Referenced by Excludes1 notes
- E72 — Other disorders of amino-acid metabolism[Excludes1](via M10.-): “gout (M1A.-, M10.-)”— CMS ICD-10-CM tabular instructional notes · icd10cm-fy2026
- E79 — Disorders of purine and pyrimidine metabolism[Excludes1](via M10.-): “gout (M1A.-, M10.-)”— CMS ICD-10-CM tabular instructional notes · icd10cm-fy2026
- M1A — Chronic gout[Excludes1](via M10.-): “gout NOS (M10.-)”— CMS ICD-10-CM tabular instructional notes · icd10cm-fy2026
Referenced by Excludes2 notes
- M1A — Chronic gout[Excludes2](via M10.-): “acute gout (M10.-)”— CMS ICD-10-CM tabular instructional notes · icd10cm-fy2026
Referenced by Code First instructions
- G99.0 — Autonomic neuropathy in diseases classified elsewhere[Code First](via M10.-): “gout (M1A.-, M10.-)”— CMS ICD-10-CM tabular instructional notes · icd10cm-fy2026
- H22 — Disorders of iris and ciliary body in diseases classified elsewhere[Code First](via M10.-): “gout (M1A.-, M10.-)”— CMS ICD-10-CM tabular instructional notes · icd10cm-fy2026
- H62.8 — Other disorders of external ear in diseases classified elsewhere[Code First](via M10.-): “gout (M1A.-, M10.-)”— CMS ICD-10-CM tabular instructional notes · icd10cm-fy2026
- I43 — Cardiomyopathy in diseases classified elsewhere[Code First](via M10.0.-): “gout (M10.0-)”— CMS ICD-10-CM tabular instructional notes · icd10cm-fy2026
- N08 — Glomerular disorders in diseases classified elsewhere[Code First](via M10.-): “gout (M1A.-, M10.-)”— CMS ICD-10-CM tabular instructional notes · icd10cm-fy2026
- N22 — Calculus of urinary tract in diseases classified elsewhere[Code First](via M10.-): “gout (M1A.-, M10.-)”— CMS ICD-10-CM tabular instructional notes · icd10cm-fy2026
Nearest codes (40)
- M10 — Gout[Sibling]— CMS ICD-10-CM tabular structure · icd10cm-fy2026
- M10.0 — Idiopathic gout[Sibling]— CMS ICD-10-CM tabular structure · icd10cm-fy2026
- M10.00 — Idiopathic gout, unspecified site[Sibling]— CMS ICD-10-CM tabular structure · icd10cm-fy2026
- M10.01 — Idiopathic gout, shoulder[Sibling]— CMS ICD-10-CM tabular structure · icd10cm-fy2026
- M10.011 — Idiopathic gout, right shoulder[Sibling]— CMS ICD-10-CM tabular structure · icd10cm-fy2026
- M10.012 — Idiopathic gout, left shoulder[Sibling]— CMS ICD-10-CM tabular structure · icd10cm-fy2026
- M10.019 — Idiopathic gout, unspecified shoulder[Sibling]— CMS ICD-10-CM tabular structure · icd10cm-fy2026
- M10.02 — Idiopathic gout, elbow[Sibling]— CMS ICD-10-CM tabular structure · icd10cm-fy2026
- and 32 more
Change history
- FY2016 — In the code set at ICD-10-CM adoption [Change history]— CMS release files (code change ledger) · icd10cm-fy2016
Common coding questions
Can M10.04 be billed directly?
No. M10.04 (Idiopathic gout, hand) is a non-billable ICD-10-CM category code. A more specific billable subcode must be selected based on clinical documentation.
Sources for this page
Codes, titles, notes, index terms and mappings on this page are transcribed from the datasets below. Relationships MedCoder computed and text MedCoder wrote are labelled where they appear.
- Code, title, tabular notes and index terms Official source data
- CMS/CDC ICD-10-CM FY2026 tabular list, index and tables, effective October 1, 2025 Release, file and checksum · Publisher’s page
- Claim edits Official source data
- CMS Definitions of Medicare Code Edits — v43.1 (April 2026) Release, file and checksum · Publisher’s page
- Change history and date-of-service validity Official source data
- CMS ICD-10-CM release addenda, ingested release by release into the change ledger Release, file and checksum · Publisher’s page
- Comparisons, relationships and the contextual map MedCoder structured relationship
- Computed by MedCoder from the tabular notes and tables above; every derived relationship is marked as derived where it appears
- Summary and FAQ answers MedCoder explanation
- Written by MedCoder to explain the sources above: drafted with AI assistance, checked by a person against the release files, and labelled as MedCoder text where it appears. Not official text.
Labels on this page: Official source data · MedCoder structured relationship · MedCoder explanation. How to read the labels · All data sources and release dates
Cite this page
Reference this page in a research guide, syllabus or article. The release is included because code content changes each year.
MedCoder.ai. "M10.04 — Idiopathic gout, hand." ICD-10-CM FY2026. https://medcoder.ai/icd10/code/m10.04-idiopathic-gout-hand
Change history
- FY2016 — October 1, 2015In the code set at ICD-10-CM adoptionIdiopathic gout, hand
No changes since FY2016 — additions, deletions, description changes and billable-status changes are tracked through FY2027 (effective October 1, 2026), and none are recorded for this code. Note changes are tracked from FY2027 only.
Nearest Codes in This Family
Official ICD-10-CM classifications closest to M10.04 in its code family, with their registry titles.
- M10.029 — Idiopathic gout, unspecified elbow
- M10.03 — Idiopathic gout, wrist
- M10.031 — Idiopathic gout, right wrist
- M10.032 — Idiopathic gout, left wrist
- M10.039 — Idiopathic gout, unspecified wrist
- M10.041 — Idiopathic gout, right hand
- M10.042 — Idiopathic gout, left hand
- M10.049 — Idiopathic gout, unspecified hand
- M10.05 — Idiopathic gout, hip
- M10.051 — Idiopathic gout, right hip