Patient presents with acute onset of severe pain, redness, swelling, and tenderness in the left great toe, consistent with acute gouty arthritis.  Symptoms began abruptly two days ago and progressively worsened.  The patient reports experiencing exquisite pain with even light touch to the affected area.  He denies fever, chills, or trauma.  Past medical history is significant for hyperuricemia and hypertension.  Family history is positive for gout.  On physical examination, the left great toe is erythematous, edematous, and warm to the touch.  Range of motion is significantly limited due to pain.  No tophi are noted.  Serum uric acid level is elevated at 9.2 mgdL.  Diagnosis of gout in the left great toe is made based on clinical presentation, elevated serum uric acid, and absence of other likely etiologies such as septic arthritis.  Treatment plan includes initiation of Indomethacin 50 mg three times daily for acute pain management.  Patient education provided on lifestyle modifications including dietary adjustments to lower purine intake, increased hydration, and weight management.  Follow-up appointment scheduled in one week to monitor symptoms and adjust medication as needed.  Differential diagnosis includes pseudogout, septic arthritis, and cellulitis.  ICD-10 code M10.001 is assigned for gout of the right great toe, and the appropriate laterality code will be appended for the left great toe.  CPT codes will be determined based on the specific evaluation and management services provided.