M1A.0211
M1A.0211: Idiopathic chronic gout, right elbow, with tophus (tophi)
Billable / specific codeICD-10-CMright
M1A.0211 is a billable, specific ICD-10-CM code for idiopathic chronic gout, right elbow, with tophus (tophi). It is valid for submission on a claim.
Check M1A.0211 with the rest of the claim: free scrubber7th character "1": with tophus (tophi)
The appropriate 7th character is to be added to each code from category M1A
- 0
- without tophus (tophi)
- 1
- with tophus (tophi)
Excludes1 inherited from the categories above M1A.0211
A category’s note binds every code beneath it.
Excludes2 inherited from the categories above M1A.0211
Not part of this code, but both may be coded when both are present.
Other codes that can never be billed with M1A.0211
Their own Excludes1 notes name this code, so the conflict is not listed above.
Risk adjustment
No CMS-HCC V28 category: this code does not change a RAF score.
Medicare coverage
M1A.0211 is named in 10 Medicare coverage policies: 3 listing it as supporting medical necessity, and 7 listing it as NOT covered. Which one applies depends on your Medicare contractor.
- A58865Billing and Coding: Amniotic and Placental-Derived Product Injections and/or Applications for Musculoskeletal Indications, Non-Woundnot covered
- A58883Billing and Coding: Amniotic and Placental-Derived Product Injections and/or Applications for Musculoskeletal Indications, Non-Woundnot covered
- A58893Billing and Coding: Amniotic and Placental-Derived Product Injections and/or Applications for Musculoskeletal Indications, Non-Woundnot covered
- A59374Billing and Coding: Amniotic and Placental-Derived Product Injections and/or Applications for Musculoskeletal Indications, Non-Woundnot covered
Code history
Unchanged in every release from FY2024 to FY2027.