ICD-10 M1A
Non-Billable HeaderChronic gout
About ICD-10-CM M1A
ICD-10-CM code M1A represents Chronic gout. This is a non-billable header code in the Musculoskeletal and Connective Tissue chapter (block M1A). The 2026 edition of ICD-10-CM M1A became effective on October 1, 2025. Non-billable codes cannot be used as a primary or secondary diagnosis on a claim, use a more specific child code instead.
Type 1 Excludes
Pure excludes, these codes can never be coded together with M1A. The conditions are mutually exclusive (e.g., congenital vs acquired forms).
- gout NOS (M10.-)
Type 2 Excludes
Not included here, the excluded code is not part of M1A, but a patient may have both conditions at the same time. Both codes may be coded together when applicable.
- acute gout (M10.-)
Use Additional Code
When coding M1A, also report these additional codes when applicable.
- 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)
Coding Notes
Seven Chr Note
- The appropriate 7th character is to be added to each code from category M1A
Medicare LCD Coverage for M1A
Local Coverage Determinations (LCDs) from CMS MACs that list M1A as a covered diagnosis.
This doesn't mean the code isn't covered, it means no MAC has issued a Local Coverage Determination naming this specific code. Coverage may still apply under National Coverage Determinations or general medical-necessity rules.
Commercial Payer Coverage
Coverage policies from major commercial payers referencing M1A.
Our payer policy database covers Aetna, Cigna, Anthem, BCBS, Humana, and Medicare Advantage plans, but M1A doesn't currently appear in any indexed policy. The code may still be covered under standard plan benefits.
CPT Codes Commonly Billed with M1A
Procedures frequently paired with this diagnosis based on PayerReady's Dx↔Px linkage data.
We don't have CPT pairings indexed for this specific code yet. Use the CPT search above to find common procedures, or check your payer's published medical policy for code-specific guidance.
Codes Adjacent To M1A
Other codes in section M05-M14 (Inflammatory polyarthropathies).
ICD-10 M1A, Billing FAQ
Is ICD-10 code M1A billable? +
No, M1A is a non-billable header code. Use a more specific child code from block M1A when submitting claims.
What codes are Type 1 Excludes for M1A? +
Type 1 Excludes (never code together with M1A): gout NOS (M10.-)
What codes are Type 2 Excludes for M1A? +
Type 2 Excludes (may be coded together when both conditions exist): acute gout (M10.-)
Get the full PayerReady toolkit
Free access to CPT/ICD-10 lookup, denial appeals, fee comparator, and claim auditing with credentialing enrollment.
Start free →Run this code through our claim audit tool
Check NCCI bundling, MUE limits, and modifier logic before submission.
Try the auditor →Did this page help?
Quick signal so we know what to improve.
If you want a code reference page that doesn't exist yet, email coding@payerready.com.
Tell us what's missing or wrong: coding@payerready.com. We respond within 5 business days.
Reviewed by the PayerReady Medical Coding Team
Verified against the CMS 2026 code set on June 1, 2026.
Powered by 11K CPT · 98K ICD-10 · 860K MPFS rates · 4.5M NCCI edits · 9.5M NPIs. Our data methodology · About our coding team