Podiatry Coding & Billing Alert

You'll be able to report gouty arthropathy more accurately starting Oct. 1, thanks to a group of new diagnosis codes.

In previous versions of ICD-9-CM, you used 274.0 (Gouty arthropathy) to describe all types of gout. The additional codes will allow you to distinguish between the different conditions (acute or chronic) or presence/ absence of tophi.

ICD-9 2010 requires a fifth digit on 274.0 as follows:

"The new codes make properly coding the correct stage of this condition easier," says Arnold Beresh, DPM, CPC of Peninsula Foot and Ankle Specialists PLC in Hampton, Va. "ICD-9 2010 includes codes for the particular stage of the disease."

Gout progresses from acute to chronic. These scenarios will help guide your gouty code selection:

1. For newly diagnosed patients with acute symptoms of gout, report 274.01.

2. For patients with a history of recurrent attacks of acute gout without tophi, use 274.02.

3. If tophi are mentioned without specifying the site, assign 274.03.

4. Otherwise, if tophi were specified to the ear or other sites, such as the heart, then the old ICD-9 codes still apply: 274.81 (Gouty tophi of ear) and 274.82 (Gouty tophi of other sites) respectively.