M1A.0520 — Idiopathic chronic gout, left hip, without tophus (tophi)
Is M1A.0520 billable?
Yes — M1A.0520 is billable for FY2027. M1A.0520 is a valid, billable ICD-10-CM code at the highest level of specificity in its branch. M1A.0520 may be submitted for encounters from October 1, 2026 through September 30, 2027.
M1A.0520 at a glance
| Code | M1A.0520 |
|---|---|
| Description | Idiopathic chronic gout, left hip, 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.0520?
In M1A.0520, the 7th character 0 means without tophus (tophi). The 7th character is required for M1A.0520 to be a valid, complete code.
Same condition, different episode of care — switch the 7th character:
Which MS-DRGs does M1A.0520 group to?
M1A.0520 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.0520 listed in the Alphabetic Index?
The Alphabetic Index lists these routes under M1A.05, the nearest indexed parent of M1A.0520. Use them to find the family, then select the specific code.
- Gout, chronic › idiopathic › hip
Excludes1 — never code together — inherited from M1A
The conditions below can never be reported together with M1A.0520 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.0520 to fully describe the condition. M1A.0520 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.0520, but a patient may have both at the same time. When documentation supports it, M1A.0520 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.0520, but a patient may have both at the same time. When documentation supports it, M1A.0520 and the excluded code may both be reported.
- acute gout (M10.-)
How long has M1A.0520 existed?
M1A.0520 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.