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M1A.4510 ICD-10-CM Code: Other secondary chronic gout, right hip, without tophus (tophi)

M1A.4510 is not a CMS-HCC payment code. MEAT criteria · RAF calculator · HCC coding software

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

M1A.4510

Billable / SpecificICD-10-CMOfficial ICD-10-CMCodebook guidance

Other secondary chronic gout, right hip, without tophus (tophi)

Other secondary chronic gout, right hip, without tophus (tophi)

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
M1A.45Other secondary chronic gout, hip
M1A.451Other secondary chronic gout, right hip
M1A.4510Other secondary chronic gout, right hip, without tophus (tophi)

Inclusion Terms

Official

ICD-10-CM does not list inclusion terms for M1A.4510 in this effective period.

Excludes 2

Official

ICD-10-CM does not list Excludes 2 notes for M1A.4510 in this effective period.

Related Child Codes

Official
M1A.4511Other secondary chronic gout, right hip, with tophus (tophi)

Includes

Official

ICD-10-CM does not list Includes notes for M1A.4510 in this effective period.

Excludes 1

Official

ICD-10-CM does not list Excludes 1 notes for M1A.4510 in this effective period.

Code First

Official

ICD-10-CM does not list Code First sequencing instructions for M1A.4510 in this effective period.

Use Additional

Official

ICD-10-CM does not list Use Additional Code instructions for M1A.4510 in this effective period.

Code Also

Official

ICD-10-CM does not list Code Also instructions for M1A.4510 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 →

Is M1A.4510 an HCC code?

No. M1A.4510 is a billable ICD-10-CM code but does not map to any HCC category in V28, V24, ESRD, or RxHCC.

Code
M1A.4510
Description
Other secondary chronic gout, right hip, without tophus (tophi)
HCC (V28)
No CMS-HCC V28 mapping
RAF
Billable
Yes
Payment year
2026

Coder workflow notes

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This code does not map to an HCC category in any model (V28, V24, ESRD, RxHCC).

What This Code Means

M1A.4510 is the ICD-10-CM diagnosis code for other secondary chronic gout, right hip, without tophus (tophi). M1A.4510 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).

M1A.4510 is a billable ICD-10-CM code but does not map to a payment HCC under the CMS-HCC V28, V24, ESRD, or RxHCC risk adjustment models. It can be reported on Medicare Advantage encounter data submissions but it does not contribute to a beneficiary's RAF score and therefore does not affect risk-adjusted payments to the plan.

M1A.4510 is a billable ICD-10-CM code that can be reported on claims but does not currently contribute to a Medicare Advantage member's RAF score under any CMS risk adjustment model (V28, V24, ESRD, or RxHCC). Coders reviewing M1A.4510 should check whether additional documentation would support a more specific child code in the same hierarchy that does map to a payment HCC, capturing the correct specificity is the highest-impact RAF improvement available within accurate coding.

HCC Buddy maintains structured V28 and V24 mapping, RAF weights, and MEAT documentation criteria for M1A.4510 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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