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M1A.09 ICD-10-CM Code: Idiopathic chronic gout, multiple sites

M1A.09 is not a CMS-HCC payment code. MEAT criteria · RAF calculator · HCC Buddy coding tools

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

M1A.09

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

Idiopathic chronic gout, multiple sites

Idiopathic chronic gout, multiple sites

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
M1AChronic gout
M1A.0Idiopathic chronic gout
M1A.09Idiopathic chronic gout, multiple sites

Inclusion Terms

Official
  • Chronic gouty bursitis
  • Primary chronic gout

Excludes 2

Official

ICD-10-CM does not list Excludes 2 notes for M1A.09 in this effective period.

Related Child Codes

Official
M1A.00Idiopathic chronic gout, unspecified site
M1A.01Idiopathic chronic gout, shoulder
M1A.02Idiopathic chronic gout, elbow
M1A.03Idiopathic chronic gout, wrist
M1A.04Idiopathic chronic gout, hand

Includes

Official

ICD-10-CM does not list Includes notes for M1A.09 in this effective period.

Excludes 1

Official

ICD-10-CM does not list Excludes 1 notes for M1A.09 in this effective period.

Code First

Official

ICD-10-CM does not list Code First sequencing instructions for M1A.09 in this effective period.

Use Additional

Official

ICD-10-CM does not list Use Additional Code instructions for M1A.09 in this effective period.

Code Also

Official

ICD-10-CM does not list Code Also instructions for M1A.09 in this effective period.

Current with CMS: FY2026 ICD-10-CM Apr 1 update (effective Apr 1 – Sep 30, 2026) · CMS-HCC V28, 100% phased in for payment year 2026. FY2027 code set already staged for October 1, 2026. How HCC Buddy stays current →

Code
M1A.09
Description
Idiopathic chronic gout, multiple sites
HCC (V28)
No CMS-HCC V28 mapping
RAF
Billable
No
Payment year
2026

Coder workflow notes

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What This Code Means

M1A.09 is the ICD-10-CM diagnosis code for idiopathic chronic gout, multiple sites. M1A.09 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 M1A.09 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 M1A.09'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 M1A.09 sourced directly from the CMS-HCC risk adjustment model files and the CMS ICD-10-CM code set.

Child Codes

Code Hierarchy

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