Orthopedic Coding Alert

Question: Encounter notes indicate that the provider performed a level-two office evaluation and management (E/M) service for a patient with “podagra.” What does this term mean, and which diagnosis codes do I use for patients with podagra?

Kentucky Subscriber

Answer: For coding purposes, podagra is a synonym for gout. The diagnosis code for podagra is the same as it is for gout: M10.- (Gout). You’d also use M10.0 to identify acute gout, gout attack, and gout flare.

Not so fast: All M10.- diagnoses require a fourth character to further specify the gout type. Make sure you choose from one of the following four-character options for your gout claims:

• M10.0- (Idiopathic gout)
• M10.1- (Lead-induced gout)
• M10.2- (Drug-induced gout)
• M10.3- (Gout due to renal impairment)
• M10.4- (Other secondary gout)

Note: You’ll need to code all M10.- diagnoses down to the sixth character, so don’t just stop at the fourth character. Choose the type of gout (podagra) from the list above, and then choose fifth and sixth characters to pinpoint the gout type and location.