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M1A.20X0 ICD-10-CM Code: Drug-induced chronic gout, unspecified site, without 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 553 — BONE DISEASES AND ARTHROPATHIES WITH MCC (MDC 08)
  • MS-DRG 554 — BONE DISEASES AND ARTHROPATHIES WITHOUT MCC (MDC 08)

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

Drug-induced chronic gout, unspecified site, without tophus (tophi) is a billable ICD-10-CM diagnosis code (M1A.200).

Official Tabular Instructional Notes

Sequencing, inclusion, and exclusion notes published for M1A.20X0 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).

Excludes2 — Not Included Here

Conditions not covered by this code, but which may be reported alongside it when both are present.

Use Additional Code

Supplementary codes the tabular list directs you to add.

  • Use additional code for adverse effect, if applicable, to identify drug (T36-T50 with fifth or sixth character 5)
  • 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)

Frequently Compared Codes

The official Excludes notes on M1A.20X0 name these codes. Each comparison page covers when the two can — or must not — be reported together.

Change history

No changes recorded for this code — unchanged since the FY2016 baseline of the change ledger.

Verify Before Coding

  • No Medicare Code Editor or MS-DRG Definitions Manual restrictions apply to this code.

From the code registry, the Medicare Code Editor, and the MS-DRG Definitions Manual. Check it against a full claim.

Relationships & Classification

Official ICD-10-CM tabular notes on other codes that name M1A.20X0 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.-).

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 553 (MDC 08), DRG 554 (MDC 08).

From the CMS MS-DRG Definitions Manual (Appendices B and C). Actual DRG assignment depends on the complete claim.

Clinical classification (AHRQ CCSR):INJ030 — Drug induced or toxic related condition (default); MUS033 — Gout.

Clinical Classifications Software Refined (CCSR) for ICD-10-CM Diagnoses. Healthcare Cost and Utilization Project (HCUP), Agency for Healthcare Research and Quality.

Contextual Map

Every relationship of M1A.20X0 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.-)” · check together
  • E79 — Disorders of purine and pyrimidine metabolism [Excludes1](via M1A.-): “gout (M1A.-, M10.-)” · check together

Referenced by Excludes2 notes

  • H61.1 — Noninfective disorders of pinna [Excludes2](via M1A.-): “gouty tophi of ear (M1A.-)” · check together
  • M10 — Gout [Excludes2](via M1A.-): “chronic gout (M1A.-)” · check together

Referenced by Code First instructions

  • G99.0 — Autonomic neuropathy in diseases classified elsewhere [Code First](via M1A.-): “gout (M1A.-, M10.-)” · check together
  • H22 — Disorders of iris and ciliary body in diseases classified elsewhere [Code First](via M1A.-): “gout (M1A.-, M10.-)” · check together
  • H62.8 — Other disorders of external ear in diseases classified elsewhere [Code First](via M1A.-): “gout (M1A.-, M10.-)” · check together
  • N08 — Glomerular disorders in diseases classified elsewhere [Code First](via M1A.-): “gout (M1A.-, M10.-)” · check together
  • N22 — Calculus of urinary tract in diseases classified elsewhere [Code First](via M1A.-): “gout (M1A.-, M10.-)” · check together

Clinical classification (CCSR)

  • INJ030 — Drug induced or toxic related condition [CCSR]
  • MUS033 — Gout [CCSR]

Potential MS-DRG

  • DRG 553 — BONE DISEASES AND ARTHROPATHIES WITH MCC [MS-DRG]: “BONE DISEASES AND ARTHROPATHIES WITH MCC (MDC 08)”
  • DRG 554 — BONE DISEASES AND ARTHROPATHIES WITHOUT MCC [MS-DRG]: “BONE DISEASES AND ARTHROPATHIES WITHOUT MCC (MDC 08)”

MDC crossing · procedures (18508)

  • MDC 08 — Diseases and Disorders of the Musculoskeletal System and Connective Tissue [MDC crossing]: “Diseases and Disorders of the Musculoskeletal System and Connective Tissue — the grouper's crossing between diagnoses and procedures: a principal diagnosis sets the MDC, and same-MDC procedures move the stay to its surgical DRGs.”
  • 005T0ZZ — Destruction of Spinal Meninges, Open Approach [Same-MDC procedure]: “Destruction of Spinal Meninges, Open Approach — grouped in MDC 08, the procedure side of this code's crossing.” · check together
  • 005T3ZZ — Destruction of Spinal Meninges, Percutaneous Approach [Same-MDC procedure]: “Destruction of Spinal Meninges, Percutaneous Approach — grouped in MDC 08, the procedure side of this code's crossing.” · check together
  • 005T4ZZ — Destruction of Spinal Meninges, Percutaneous Endoscopic Approach [Same-MDC procedure]: “Destruction of Spinal Meninges, Percutaneous Endoscopic Approach — grouped in MDC 08, the procedure side of this code's crossing.” · check together
  • 005W0Z3 — Destruction of Cervical Spinal Cord using Laser Interstitial Thermal Therapy, Open Approach [Same-MDC procedure]: “Destruction of Cervical Spinal Cord using Laser Interstitial Thermal Therapy, Open Approach — grouped in MDC 08, the procedure side of this code's crossing.” · check together
  • 005W0ZZ — Destruction of Cervical Spinal Cord, Open Approach [Same-MDC procedure]: “Destruction of Cervical Spinal Cord, Open Approach — grouped in MDC 08, the procedure side of this code's crossing.” · check together
  • and 18503 more

Nearest codes (40)

  • M1A — Chronic gout [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]
  • M1A.1710 — Lead-induced chronic gout, right ankle and foot, without tophus (tophi) [Sibling]
  • M1A.1711 — Lead-induced chronic gout, right ankle and foot, with tophus (tophi) [Sibling]
  • M1A.172 — Lead-induced chronic gout, left ankle and foot [Sibling]
  • and 32 more

Frequently Asked Questions (FAQ) & Clinical Guidance

Does M1A.20X0 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.20X0 in its code family, with their registry titles.

  • M1A.19 — Lead-induced chronic gout, multiple sites
  • M1A.19X0 — Lead-induced chronic gout, multiple sites, without tophus (tophi)
  • M1A.19X1 — Lead-induced chronic gout, multiple sites, with tophus (tophi)
  • M1A.2 — Drug-induced chronic gout
  • M1A.20 — Drug-induced chronic gout, unspecified site
  • M1A.20X1 — Drug-induced chronic gout, unspecified site, with tophus (tophi)
  • M1A.21 — Drug-induced chronic gout, shoulder
  • M1A.211 — Drug-induced chronic gout, right shoulder
  • M1A.2110 — Drug-induced chronic gout, right shoulder, without tophus (tophi)
  • M1A.2111 — Drug-induced chronic gout, right shoulder, with tophus (tophi)

View all codes in the M1A family