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M10 ICD-10-CM Code: Gout

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FY 2026 Apr update / Diseases of the musculoskeletal system and connective tissue (M00-M99) / Inflammatory polyarthropathies (M05-M14)

M10

Header CodeICD-10-CMOfficial ICD-10-CMCodebook guidance

Gout

Gout

CMS-HCC V28

N/A

Not mapped

CMS-HCC V24

N/A

Not mapped

ACA/HHS

N/A

Not mapped

ESRD/PACE

N/A

Not mapped

RXHCC

N/A

Not mapped

Code Book Path

Official
M1Inflammatory polyarthropathies (M05-M14)
M10Gout

Inclusion Terms

Official
  • Acute gout
  • Gout attack
  • Gout flare
  • Podagra

Excludes 2

Official
  • chronic gout (M1A.-)

Related Child Codes

Official
M10.0Idiopathic gout
M10.1Lead-induced gout
M10.2Drug-induced gout
M10.3Gout due to renal impairment
M10.4Other secondary gout

Includes

Official

ICD-10-CM does not list Includes notes for M10 in this effective period.

Excludes 1

Official

ICD-10-CM does not list Excludes 1 notes for M10 in this effective period.

Code First

Official

ICD-10-CM does not list Code First sequencing instructions for M10 in this effective period.

Use Additional

Official
  • 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-)

Code Also

Official

ICD-10-CM does not list Code Also instructions for M10 in this effective period.

Last updated: FY2026 ICD-10-CM Apr update, Apr 1, 2026 through Sep 30, 2026. CMS-HCC V28 is 100% phased in for payment year 2026.

Coder workflow notes

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What This Code Means

M10 is the ICD-10-CM diagnosis code for gout. M10 sits in the ICD-10-CM chapter for diseases of the musculoskeletal system and connective tissue (m00-m99), within the section covering inflammatory polyarthropathies (m05-m14).

Header codes like M10 cannot be reported on claims directly, they organize child codes that share clinical context but the actual diagnosis must be coded to the highest level of specificity supported by the documentation. Coders should look at M10's child codes and select the one that matches the patient's documented presentation, since payers reject header codes submitted as the primary diagnosis. For risk adjustment workflows, header codes never contribute to a Medicare Advantage member's RAF score on their own; only billable child codes that happen to map to a payment HCC affect risk-adjusted plan payments.

HCC Buddy maintains structured V28 and V24 mapping, RAF weights, and MEAT documentation criteria for M10 sourced directly from the CMS-HCC risk adjustment model files and the CMS ICD-10-CM code set.

Excludes 2, Not included here, may code separately

  • chronic gout (M1A.-)

Use Additional Code

  • 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)

Child Codes

Code Hierarchy

M10Gout
M10Gout

Work M10 in HCC Buddy

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