M10.29

Drug-induced gout affecting multiple joint sites simultaneously, where a causative medication is responsible for triggering urate crystal deposition and inflammatory arthritis across more than one anatomical location.

Verified May 8, 2026 · 5 sources ↓

Status: Billable
Chapter: 13
Related CPT: 7
Region: Multi-region

Drawn from CDCICD10DataAAPCPrecisionhubOutsourcestrategies

Documentation tips

What should appear in the chart to support M10.29.

Source · Editorial brief grounded in 5 cited references ↓

Name every joint involved — list each affected site explicitly (e.g., 'bilateral ankles and right wrist') so that multi-site status is unambiguous and M10.29 is defensible over a single-site code.
Identify the causative drug by name and link it as the precipitating agent; document whether it is a prescribed medication taken as directed, which confirms adverse effect rather than poisoning.
Add the corresponding T36–T50 adverse effect code with 5th or 6th character 5 on every claim — this is a required ICD-10-CM instructional note, not optional.
Record serum uric acid level and any joint aspiration findings (monosodium urate crystals under polarized light) to substantiate the gout diagnosis clinically.
Note the timeline: when did the drug start relative to symptom onset? This causality link supports the drug-induced etiology over idiopathic gout.

Related CPT procedures

Procedure codes commonly billed with M10.29. Linking the right diagnosis to the right procedure is what establishes medical necessity.

Source · CMS LCDs · AAOS specialty guidance · claims-pattern analysis

20610 $68.81

Aspiration and/or injection of a major joint or bursa (shoulder, hip, knee, or subacromial bursa) performed without ultrasound guidance.

20611 $104.21

Aspiration or injection of a major joint or bursa performed under real-time ultrasound guidance, with permanent image documentation.

99213 $95.19

Established patient office or outpatient visit requiring 20–29 minutes of total time or low-complexity medical decision-making.

99214 $135.61

Office visit for an established patient requiring moderate-complexity medical decision making (MDM), or 30–39 minutes of total provider time on the date of service.

99215 $192.39

Highest-level office or outpatient E/M visit for an established patient, qualifying via high-complexity medical decision making or 40–54 minutes of total provider time on the date of service.

83825 View procedure details

86431 View procedure details

Common coding pitfalls

The recurring mistakes coders make with M10.29 and adjacent codes.

Source · Editorial brief grounded in CDC ICD-10-CM tabular guidance, AAOS coding references, and cited references ↓

Omitting the T36–T50 adverse effect code — the ICD-10-CM tabular instructs coders to add it; submitting M10.29 alone is an incomplete code assignment.
Defaulting to M10.20 (unspecified site) when the note actually documents two or more specific joints — read the encounter note for every joint mentioned before selecting the unspecified-site code.
Using M10.9 (gout, unspecified) when both etiology (drug-induced) and multi-site involvement are clearly documented — M10.9 is a last resort when no further specificity is available.
Confusing drug-induced gout (M10.2x, adverse effect) with gout due to renal impairment (M10.3x) — if the patient also has CKD, confirm which condition the provider identifies as the causative factor before coding.
Coding M10.29 for a single-joint flare in a patient with a history of multi-joint involvement — code the current encounter's active joint(s); use the site-specific code if only one joint is affected at this visit.

Clinical context

Source · Editorial summary grounded in 5 cited references ↓

M10.29 is the correct code when documented drug-induced gout involves multiple joints — for example, concurrent flares in both feet and one knee, or bilateral ankles plus a wrist. The key distinction from M10.20 (unspecified site) is that the provider has identified involvement at more than one discrete joint region. If only a single joint is affected, drop to the site-specific code: M10.261 (right knee), M10.271 (right ankle and foot), etc.

This code carries a mandatory instructional note: you must add a secondary code from T36–T50 with a 5th or 6th character of 5 to identify the offending drug as an adverse effect. Common culprits include diuretics (especially thiazides and loop diuretics), low-dose aspirin, cyclosporine, and niacin. Without that T-code, the claim is incomplete and may be returned or denied.

M10.29 groups to MS-DRG 553 (Bone diseases and arthropathies with MCC) or 554 (without MCC). Distinguish drug-induced gout from gout due to renal impairment (M10.3x), lead-induced gout (M10.1x), and idiopathic/primary gout (M10.0x) — the etiologic distinction drives the entire code family selection.

Sibling codes

Other billable codes under M10.2 (laterality / anatomic variants).

M10.28

Drug-induced gout, vertebrae

M10.20

Drug-induced gout, unspecified site

Frequently asked questions

Source · Generated from the editorial pipeline, verified against 5 cited references ↓

01Do I always need a second code with M10.29?

Yes. The ICD-10-CM tabular includes a mandatory 'code for adverse effect' instruction: add a code from T36–T50 with a 5th or 6th character of 5 to identify the causative drug. Submitting M10.29 without it is an incomplete code assignment.

02How many joints need to be involved to use M10.29 instead of a site-specific code?

Two or more distinct joint sites must be documented as actively affected. If the flare is isolated to one joint — even in a patient with a history of polyarticular gout — use the appropriate single-site code (e.g., M10.261 for right knee).

03What separates M10.29 from M10.20?

M10.20 is drug-induced gout at an unspecified site — use it only when no joint location is documented. M10.29 requires explicit documentation of multiple specific sites. If the note names any joints at all, M10.20 is not appropriate.

04Can M10.29 be used if the patient also has chronic kidney disease?

Only if the provider's documentation attributes the gout to the drug, not to the renal impairment. If CKD is identified as the causative factor, M10.3x is correct. If both conditions are present but the note clearly implicates a medication, M10.29 with the appropriate T-code is appropriate.

05Which drugs most commonly trigger drug-induced gout requiring M10.29?

Thiazide and loop diuretics are the most frequently implicated, followed by low-dose aspirin, cyclosporine, and niacin. Document the specific agent by name in the encounter note so the corresponding T-code can be assigned accurately.

06Is M10.29 valid for chronic polyarticular drug-induced gout, or only acute flares?

M10.29 applies to drug-induced gout broadly — acute flare or established chronic presentation — as long as multiple sites are involved and the drug etiology is documented. For chronic tophaceous presentations, also evaluate whether M1A (chronic gout) codes are more appropriate per the tabular guidance.

Sources & references

Editorial content was developed using the following public sources. Last verified May 8, 2026.

Mira AI Scribe

Mira's AI scribe captures the specific joints involved in the flare (e.g., 'bilateral ankles and right knee'), the implicated medication by name and dosing context, serum uric acid results, and any synovial fluid crystal analysis — preventing the omission of the required adverse-effect T-code pairing and stopping downcoding to unspecified-site M10.20 or non-specific M10.9.

See how Mira captures M10.29 documentation