ICD-10-CM 2026 · Effective October 1, 2025

ICD-10 M1A.4211

Billable / Specific

Other secondary chronic gout, right elbow, with tophus (tophi)

M1A
Block
0
Synonyms
129
LCDs
3
Payer Policies
0
Linked CPTs

About ICD-10-CM M1A.4211

ICD-10-CM code M1A.4211 represents Other secondary chronic gout, right elbow, with tophus (tophi). This is a billable/specific code in the Musculoskeletal and Connective Tissue chapter (block M1A). The 2026 edition of ICD-10-CM M1A.4211 became effective on October 1, 2025.

Medicare LCD Coverage for M1A.4211

Local Coverage Determinations (LCDs) from CMS MACs that list M1A.4211 as a covered diagnosis.

129 LCDs

Showing top 10 of 129 total . Click a CPT for full coverage scope.

CMS LCD: Billing and Coding: Pharmacogenomics Testing
Article ID: 58801, Effective: 2026-01-01 00:00:00, 578 covered, 0 non-covered
CPT 81227 →
CMS LCD: Billing and Coding: Pharmacogenomics Testing
Article ID: 58801, Effective: 2026-01-01 00:00:00, 578 covered, 0 non-covered
CPT 81328 →
CMS LCD: Billing and Coding: Pharmacogenomics Testing
Article ID: 58801, Effective: 2026-01-01 00:00:00, 578 covered, 0 non-covered
CPT 81335 →
CMS LCD: Billing and Coding: Pharmacogenomics Testing
Article ID: 58801, Effective: 2026-01-01 00:00:00, 578 covered, 0 non-covered
CPT 0071U →
CMS LCD: Billing and Coding: Pharmacogenomics Testing
Article ID: 58801, Effective: 2026-01-01 00:00:00, 578 covered, 0 non-covered
CPT 81383 →
CMS LCD: Billing and Coding: Pharmacogenomics Testing
Article ID: 58801, Effective: 2026-01-01 00:00:00, 578 covered, 0 non-covered
CPT 81418 →
CMS LCD: Billing and Coding: Pharmacogenomics Testing
Article ID: 58801, Effective: 2026-01-01 00:00:00, 578 covered, 0 non-covered
CPT 0073U →
CMS LCD: Billing and Coding: Pharmacogenomics Testing
Article ID: 58801, Effective: 2026-01-01 00:00:00, 578 covered, 0 non-covered
CPT 81283 →
CMS LCD: Billing and Coding: Pharmacogenomics Testing
Article ID: 58801, Effective: 2026-01-01 00:00:00, 578 covered, 0 non-covered
CPT 81408 →
CMS LCD: Billing and Coding: Pharmacogenomics Testing
Article ID: 58801, Effective: 2026-01-01 00:00:00, 578 covered, 0 non-covered
CPT 81355 →

Commercial Payer Coverage

Coverage policies from major commercial payers referencing M1A.4211.

3 policies

3 Medicare

Billing and Coding: Pharmacogenomics Testing
Policy ID: ART-58801
Billing and Coding: Pharmacogenomics Testing
Policy ID: ART-58812
Billing and Coding: Pharmacogenomic Testing
Policy ID: ART-59915

CPT Codes Commonly Billed with M1A.4211

Procedures frequently paired with this diagnosis based on PayerReady's Dx↔Px linkage data.

No procedure linkages on file for M1A.4211

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.

Convert M1A.4211 to ICD-9-CM

Per CMS General Equivalence Mappings (GEMs), useful for legacy data review and historical claim analysis.

ICD-10ICD-9Mapping Flags
M1A.4211 27403 10000

Flags format (5 digits): Approximate · No Map · Combination · Scenario · Choice List. Source: CMS 2017 GEMs (final version).

ICD-10 M1A.4211, Billing FAQ

Is ICD-10 code M1A.4211 billable? +

Yes, M1A.4211 is a billable ICD-10-CM code that can appear as a primary or secondary diagnosis on claims.

What ICD-9 codes does M1A.4211 map to? +

Per CMS GEMs, M1A.4211 maps to ICD-9 codes: 27403. Useful for legacy data review and historical claim analysis.

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Reviewed by the PayerReady Medical Coding Team

Verified against the CMS 2026 code set on April 30, 2026.

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