M1A.19X1 ICD-10-CM Code: Lead-induced chronic gout, multiple sites, with tophus (tophi)
Billing Status: YES. This is a valid, specific, and billable ICD-10-CM reference.
Inpatient Payment Groups (MS-DRG)
MS-DRGs this diagnosis helps define, as principal or secondary, per the CMS ICD-10-CM/PCS MS-DRG Definitions Manual v43.0, Appendix B.
- MS-DRG 917 — POISONING AND TOXIC EFFECTS OF DRUGS WITH MCC (MDC 21)
- MS-DRG 918 — POISONING AND TOXIC EFFECTS OF DRUGS WITHOUT MCC (MDC 21)
A diagnosis appearing in a group's logic does not by itself determine the DRG assigned to a stay; the grouper uses the full claim.
Official Registry Overview & Definition
Official Tabular Instructional Notes
Sequencing, inclusion, and exclusion notes published for M1A.19X1 in the official ICD-10-CM tabular list.
Excludes1 — Not Coded Here
Conditions generally not reported together with this code (Excludes1) -- an error unless the two conditions are documented as unrelated to each other (ICD-10-CM Official Guidelines, Section I.A.12.a).
- gout NOS (M10.-) Compare M1A.19X1 vs M10 →
Excludes2 — Not Included Here
Conditions not covered by this code, but which may be reported alongside it when both are present.
- acute gout (M10.-) Compare M1A.19X1 vs M10 →
Code First
Underlying conditions that must be sequenced before this code.
- toxic effects of lead and its compounds (T56.0-)
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)
Change history
No changes recorded for this code — unchanged since the FY2016 baseline of the change ledger.
Verify Before Coding
- Billable — reportable as written.
From the code registry, the Medicare Code Editor, and the MS-DRG Definitions Manual. Check it against a full claim.
Contextual Map
Every relationship of M1A.19X1 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.
Hierarchy
- M00-M99 — Chapter 13: Diseases of the Musculoskeletal System and Connective Tissue (M00-M99) (M00-M99) [Hierarchy]
Referenced by Excludes1 notes
- E72 — Other disorders of amino-acid metabolism [Excludes1](via M1A.-): “gout (M1A.-, M10.-)”
- E79 — Disorders of purine and pyrimidine metabolism [Excludes1](via M1A.-): “gout (M1A.-, M10.-)”
Referenced by Excludes2 notes
- H61.1 — Noninfective disorders of pinna [Excludes2](via M1A.-): “gouty tophi of ear (M1A.-)”
- M10 — Gout [Excludes2](via M1A.-): “chronic gout (M1A.-)”
Referenced by Code First instructions
- G99.0 — Autonomic neuropathy in diseases classified elsewhere [Code First](via M1A.-): “gout (M1A.-, M10.-)”
- H22 — Disorders of iris and ciliary body in diseases classified elsewhere [Code First](via M1A.-): “gout (M1A.-, M10.-)”
- H62.8 — Other disorders of external ear in diseases classified elsewhere [Code First](via M1A.-): “gout (M1A.-, M10.-)”
- N08 — Glomerular disorders in diseases classified elsewhere [Code First](via M1A.-): “gout (M1A.-, M10.-)”
- N22 — Calculus of urinary tract in diseases classified elsewhere [Code First](via M1A.-): “gout (M1A.-, M10.-)”
Clinical classification (CCSR)
- MUS033 — Gout [CCSR]
Potential MS-DRG
- DRG 917 — POISONING AND TOXIC EFFECTS OF DRUGS WITH MCC [MS-DRG]: “POISONING AND TOXIC EFFECTS OF DRUGS WITH MCC (MDC 21)”
- DRG 918 — POISONING AND TOXIC EFFECTS OF DRUGS WITHOUT MCC [MS-DRG]: “POISONING AND TOXIC EFFECTS OF DRUGS WITHOUT MCC (MDC 21)”
Nearest codes (40)
- M1A — Chronic gout [Sibling]
- M1A.1620 — Lead-induced chronic gout, left knee, without tophus (tophi) [Sibling]
- M1A.1621 — Lead-induced chronic gout, left knee, with tophus (tophi) [Sibling]
- M1A.169 — Lead-induced chronic gout, unspecified knee [Sibling]
- M1A.1690 — Lead-induced chronic gout, unspecified knee, without tophus (tophi) [Sibling]
- M1A.1691 — Lead-induced chronic gout, unspecified knee, with tophus (tophi) [Sibling]
- M1A.17 — Lead-induced chronic gout, ankle and foot [Sibling]
- M1A.171 — Lead-induced chronic gout, right ankle and foot [Sibling]
- and 32 more
Referenced by Other Codes
Clinical classification (AHRQ CCSR):MUS033 — Gout (default).
Clinical Classifications Software Refined (CCSR) for ICD-10-CM Diagnoses. Healthcare Cost and Utilization Project (HCUP), Agency for Healthcare Research and Quality.
Potential MS-DRG Relationships (FY2026)
Not on the CMS CC/MCC list — as a secondary diagnosis this code does not change MS-DRG severity.
Named in the grouper logic of 2 MS-DRGs: DRG 917 (MDC 21), DRG 918 (MDC 21).
From the CMS MS-DRG Definitions Manual (Appendices B and C). Actual DRG assignment depends on the complete claim.
Official ICD-10-CM tabular notes on other codes that name M1A.19X1 or its code family.
2 Excludes1 notes: E72 (via M1A.-), E79 (via M1A.-).
2 Excludes2 notes across 2 chapters: H61.1 (via M1A.-), M10 (via M1A.-).
5 Code First instructions across 4 chapters: G99.0 (via M1A.-), H22 (via M1A.-), H62.8 (via M1A.-), N08 (via M1A.-), N22 (via M1A.-).
Frequently Asked Questions (FAQ) & Clinical Guidance
Does M1A.19X1 require a 7th character?
Yes. The appropriate 7th character is to be added to each code from category M1A.
Nearest Codes in This Family
Official ICD-10-CM classifications closest to M1A.19X1 in its code family, with their registry titles.
- M1A.18 — Lead-induced chronic gout, vertebrae
- M1A.18X0 — Lead-induced chronic gout, vertebrae, without tophus (tophi)
- M1A.18X1 — Lead-induced chronic gout, vertebrae, with tophus (tophi)
- M1A.19 — Lead-induced chronic gout, multiple sites
- M1A.19X0 — Lead-induced chronic gout, multiple sites, without tophus (tophi)
- M1A.2 — Drug-induced chronic gout
- M1A.20 — Drug-induced chronic gout, unspecified site
- M1A.20X0 — Drug-induced chronic gout, unspecified site, without tophus (tophi)
- M1A.20X1 — Drug-induced chronic gout, unspecified site, with tophus (tophi)
- M1A.21 — Drug-induced chronic gout, shoulder