Is ICD-10-CM code M10 billable?

No, M10 (Gout) is a non-billable ICD-10-CM code. It must be coded to a more specific subcategory before it can be used for reimbursement.

What chapter does ICD-10-CM code M10 belong to?

M10 belongs to Chapter 13 of the ICD-10-CM tabular list: M00–M99 (Diseases of the Musculoskeletal System and Connective Tissue).

M10Not billable, use a more specific code below

Gout

In Inflammatory polyarthropathies (M05-M14), chapter 13: Diseases of the Musculoskeletal System and Connective Tissue

121 billable codes under M10: none are a CC or MCC; none map to an HCC.

Instructional notes

Includes: conditions that are coded here

Acute gout
Gout attack
Gout flare
Podagra

Excludes2: not included here, code separately if applicable

chronic gout (M1A.-)

Use additional code: add a second code for this, listed after this one

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)

Official coding guidelines

From the ICD-10-CM Official Guidelines for Coding and Reporting, FY 2027 (CMS and NCHS). Links open the PDF at the right page.

Covers site and laterality, acute injury versus chronic musculoskeletal conditions, 7th characters for pathologic fractures, osteoporosis with or without current fracture, and multisystem inflammatory syndrome.

Site and laterality (page 60)
Acute traumatic versus chronic or recurrent musculoskeletal conditions (page 61)
Coding of Pathologic Fractures (page 61)
Osteoporosis (page 61)
Multisystem Inflammatory Syndrome (page 62)

Read Section I.C.13 (page 60)

All codes under M10

M10 can't be used on a claim. Pick a billable code below; grey headings group them.

M10 MS-DRGs

As the principal diagnosis, the billable codes under M10 group to MS-DRG 553, 554, 698, 699, or 700 (v44.0). Which one applies depends on procedures performed, secondary diagnoses (CC/MCC), and the patient's age and discharge status.

DRG 553 Bone Diseases and Arthropathies with MCC (97 of 121 codes)
DRG 554 Bone Diseases and Arthropathies without MCC (97 of 121 codes)
DRG 698 Other Kidney and Urinary Tract Diagnoses with MCC (24 of 121 codes)
DRG 699 Other Kidney and Urinary Tract Diagnoses with CC (24 of 121 codes)
DRG 700 Other Kidney and Urinary Tract Diagnoses without CC/MCC (24 of 121 codes)

Other codes that refer to M10

Notes on these codes point to M10.

E72 Excludes1: gout (M1A.-, M10.-)
E79 Excludes1: gout (M1A.-, M10.-)
G99.0 Code First: gout (M1A.-, M10.-)
H22 Code First: gout (M1A.-, M10.-)
H62.8 Code First: gout (M1A.-, M10.-)
M1A Excludes1: gout NOS (M10.-)
M1A Excludes2: acute gout (M10.-)
N08 Code First: gout (M1A.-, M10.-)
N22 Code First: gout (M1A.-, M10.-)

About the condition

Plain-language background from MedlinePlus (National Library of Medicine), not coding guidance.

Gout

Gout is a common type of inflammatory arthritis. It causes pain, swelling, and redness in one or more joints. It usually happens as a flare, which can last for a week or two and then gets better. The flares often begin in your big toe or a lower limb.

Code history

Valid since FY2016, when ICD-10-CM took effect on October 1, 2015. No changes since.