M1A.0490 — Idiopathic chronic gout, unspecified hand, without tophus (tophi)
Is M1A.0490 billable?
Yes, but M1A.0490 is an unspecified code. M1A.0490 is a valid, billable ICD-10-CM code for encounters from October 1, 2026 through September 30, 2027. However, M1A.0490 is an unspecified or catch-all code. Payers apply additional scrutiny to unspecified codes and many deny them when the medical record supports a more specific option, so check the documentation before selecting M1A.0490 — the more specific alternatives are listed below.
M1A.0490 at a glance
| Code | M1A.0490 |
|---|---|
| Description | Idiopathic chronic gout, unspecified hand, without tophus (tophi) |
| Billable | Yes |
| Code set | ICD-10-CM FY2027 |
| Valid for encounters | October 1, 2026 – September 30, 2027 |
| 7th character "0" | without tophus (tophi) |
What does the 7th character "0" mean in M1A.0490?
In M1A.0490, the 7th character 0 means without tophus (tophi). The 7th character is required for M1A.0490 to be a valid, complete code.
Same condition, different episode of care — switch the 7th character:
Which MS-DRGs does M1A.0490 group to?
M1A.0490 sits in MDC 08 and helps define the logic of 2 MS-DRGs (version 44, FY2027). Which one a stay actually groups to also depends on procedures and secondary diagnoses.
- 553Bone Diseases and Arthropathies with MCCmedical
- 554Bone Diseases and Arthropathies without MCCmedical
How is M1A.0490 listed in the Alphabetic Index?
The Alphabetic Index lists these routes under M1A.04, the nearest indexed parent of M1A.0490. Use them to find the family, then select the specific code.
- Gout, chronic › idiopathic › hand joint
Excludes1 — never code together — inherited from M1A
The conditions below can never be reported together with M1A.0490 on the same claim. An Excludes1 note means the two conditions cannot occur in the same patient, so reporting both is a coding error.
- gout NOS (M10.-)
Use additional code — inherited from M1A
Report an additional code alongside M1A.0490 to fully describe the condition. M1A.0490 is sequenced first.
- 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)
Excludes2 — not included here — inherited from Chapter 13
The conditions below are not part of M1A.0490, but a patient may have both at the same time. When documentation supports it, M1A.0490 and the excluded code may both be reported.
- arthropathic psoriasis (L40.5-)
- certain conditions originating in the perinatal period (P04-P96)
- certain infectious and parasitic diseases (A00-B99)
- compartment syndrome (traumatic) (T79.A-)
- complications of pregnancy, childbirth and the puerperium (O00-O9A)
- congenital malformations, deformations, and chromosomal abnormalities (Q00-Q99)
- endocrine, nutritional and metabolic diseases (E00-E88)
- injury, poisoning and certain other consequences of external causes (S00-T88)
- neoplasms (C00-D49)
- symptoms, signs and abnormal clinical and laboratory findings, not elsewhere classified (R00-R94)
Excludes2 — not included here — inherited from M1A
The conditions below are not part of M1A.0490, but a patient may have both at the same time. When documentation supports it, M1A.0490 and the excluded code may both be reported.
- acute gout (M10.-)
How long has M1A.0490 existed?
M1A.0490 has been in ICD-10-CM since at least FY2016, the earliest fiscal year on record here.
Derived from the official order files for FY2016–FY2026. FY2017 and FY2020 publish no order file, so those years are not covered.