Unilateral primary osteoarthritis, left knee
What is the diagnosis code for total knee replacement?
Pain on the outer (or lateral) part of the knee can be caused by an injury. It may also be the result of inflammation in a band of tough fibrous tissue that runs down the outside of the thigh, and attaches to the front of the tibia (shin bone). Pain in this area may also be caused by arthritis.
Most people who have total knee replacement surgery experience a dramatic reduction of knee pain and a significant improvement in the ability to perform common activities of daily living. But total knee replacement will not allow you to do more than you could before you developed arthritis.
Presence of artificial knee joint, bilateral The 2022 edition of ICD-10-CM Z96. 653 became effective on October 1, 2021.
652.
Total Knee ArthroplastyCodeDescription27445ARTHROPLASTY, KNEE, HINGE PROSTHESIS (EG, WALLDIUS TYPE)27447ARTHROPLASTY, KNEE, CONDYLE AND PLATEAU; MEDIAL AND LATERAL COMPARTMENTS WITH OR WITHOUT PATELLA RESURFACING (TOTAL KNEE ARTHROPLASTY)27486REVISION OF TOTAL KNEE ARTHROPLASTY, WITH OR WITHOUT ALLOGRAFT; 1 COMPONENT1 more row
27447-58, 22—Arthroplasty, knee, condyle and plateau; medial AND lateral compartments with or without patella resurfacing (total knee arthroplasty)
Z96. 651 - Presence of right artificial knee joint. ICD-10-CM.
ICD-10 code Z47. 89 for Encounter for other orthopedic aftercare is a medical classification as listed by WHO under the range - Factors influencing health status and contact with health services .
Presence of right artificial knee joint Z96. 651 is a billable/specific ICD-10-CM code that can be used to indicate a diagnosis for reimbursement purposes. The 2022 edition of ICD-10-CM Z96. 651 became effective on October 1, 2021.
Introduction. Total knee replacement (TKR), also referred to as total knee arthroplasty (TKA), is one of the most common surgical procedures performed for patients with severe arthritis of the knee (Mahomed et al., 2005).
ICD-10 code Z47. 1 for Aftercare following joint replacement surgery is a medical classification as listed by WHO under the range - Factors influencing health status and contact with health services .
**For Part B of A services, the following CPT codes should be used:CodeDescription27130ARTHROPLASTY, ACETABULAR AND PROXIMAL FEMORAL PROSTHETIC REPLACEMENT (TOTAL HIP ARTHROPLASTY), WITH OR WITHOUT AUTOGRAFT OR ALLOGRAFT4 more rows
CPT® Code 27447 in section: Arthroplasty, knee, condyle and plateau.
Knee replacement, also called knee arthroplasty or total knee replacement, is a surgical procedure to resurface a knee damaged by arthritis. Metal and plastic parts are used to cap the ends of the bones that form the knee joint, along with the kneecap.
Presence of right artificial knee joint Z96. 651 is a billable/specific ICD-10-CM code that can be used to indicate a diagnosis for reimbursement purposes. The 2022 edition of ICD-10-CM Z96. 651 became effective on October 1, 2021.
ICD-10 code Z98. 890 for Other specified postprocedural states is a medical classification as listed by WHO under the range - Factors influencing health status and contact with health services .
Introduction. Total knee replacement (TKR), also referred to as total knee arthroplasty (TKA), is one of the most common surgical procedures performed for patients with severe arthritis of the knee (Mahomed et al., 2005).
In ICD-10-PCS, arthroscopy goes to the root operation “inspection,” which is defined as visually and/or manually exploring a body part. Therefore, an arthroscopy of the right knee is classified to code 0SJC4ZZ, and arthroscopy of the left knee is classified to code 0SJD4ZZ.
Next, let’s take a look at a practical application. Consider a total knee replacement, which consists of the replacing of all three components of the knee joint (the tibial, femoral, and patellar components). The first time the total joint is replaced with an orthopedic device, the procedure would be coded to replacement based on the definition of the ICD-10-PCS root operation of the same name. The removal of the native joint would not be coded separately because it is considered to be inherent to the process to replace the joint.
In a replacement procedure, the objective is to replace the body part or a portion of the body part. This seems pretty straightforward. A caveat to remember is that if the code for replacement is assigned, the replacement code also captures the removal of the body part being replaced, and as such the removal or excision of the body part is not coded separately. A joint replacement, a bone graft, and a free skin graft are examples of replacement procedures.
A removal procedure is coded for taking out a device that was used in a previous replacement procedure; in other words, a complete re-do. If the previously placed device is completely removed and replaced, both removal and replacement procedure codes would be assigned.
Replacement: putting in or on biological or synthetic material that physically takes the place and/or function of all or a portion of a body part. Removal: taking out or off a device from a body part. Revision: Correcting to the extent possible a portion of a malfunctioning device or the position of a displaced device.
Based on theory, it would seem that ICD-10-PCS root operations could be assigned correctly with relative ease; however, practical application sometimes intersects with coding scenarios that make one question the selection of the appropriate root operation.
For example, if you were treating a patient who had a total knee replacement, you would want to submit Z47.1, Aftercare following joint replacement surgery, as well as Z96.651 (to indicate that the joint replaced was the knee). Taking this one step further, let’s say the patient was receiving treatment for gait abnormality following a total knee replacement of the right knee due to osteoarthritis in that knee. Let’s also assume that, as a result of the surgery, the patient is no longer suffering from osteoarthritis. The appropriate codes for this scenario, according to this presentation, would be:
Remember, there are a number of orthopedic aftercare codes for specific surgeries—all of which you can find in the ICD-10 tabular list under Z47, Orthopedic aftercare.
You should add any comorbidities that may impact the rehab episode of care. You should not include osteoarthritis in the diagnostic set unless it affects other joints that will affect the episode." I hope that's helpful!
Z codes also apply to post-op care when the condition that precipitated the surgery no longer exists —but the patient still requires therapeutic care to return to a healthy level of function. In situations like these, ICD-10 provides a few coding options, including:
If there are no other codes that could further describe the patient's condition or the need for the total joint arthroplasty, then you could stick with the two Z codes. However, if you can include additional codes, we always advise doing so. I hope that helps!
If a joint was not replaced, then Z47.89 might be more appropriate as primary: http://www.icd10data.com/IC...
Even so, therapists should only use ICD-10 aftercare codes to express patient diagnoses in a very select set of circumstances.
Progress notes should consist of more than just conclusive statements. Therefore, the medical record of the joint replacement surgical patient must specifically document a complete description of the patient’s historical and clinical findings. Both physicians (includes physician treatment, evaluation and consultation records from the office to document medical necessity for surgery) and hospitals are responsible for ensuring a complete and accurate record.
Note, however, that modifier 62 may only be used when the co-surgeons are of different specialties and are working together on the same procedure.
Aftercare following explantation of a joint prosthesis is reported with a code from category Z47, denoting orthopedic aftercare. Aftercare following explantation of a joint prosthesis (Z47.3-) may be reported for a staged procedure or an encounter for evaluation of planned insertion of a new joint prosthesis following prior explantation of a joint prosthesis. In ICD-10-CM, aftercare for explantation of a joint prosthesis is specific to site.
Aftercare codes are found in categories Z42-Z49 and Z51. Aftercare is one of the 16 types of Z-codes covered in the 2012 ICD-10-CM Official Guidelines and Reporting. Aftercare visit codes cover situations occurring when the initial treatment of a disease has been performed and the patient requires continued care during the healing or recovery phase, or care for the long-term consequences of the disease.
Aftercare for injuries is reported with a V-code in ICD-9-CM. However, aftercare of injuries in ICD-10-CM is captured with the seventh character “D,” specifically denoting routine care following most injuries. For fractures, additional seventh characters for subsequent encounters apply, depending on whether the fracture is open or closed and whether the healing is routine or delayed, with nonunion or malunion.
Reason for encounter: Aftercare for traumatic fracture is reported with code S82.224D, Nondisplaced transverse fracture of shaft of right tibia, subsequent encounter for closed fracture with routine healing.
Codes for encounters for antineoplastic radiation, chemotherapy and immunotherapy (Z51.0, Z51.1-) are assigned if the sole reason for the encounter is antineoplastic therapy – even if the patient still has the neoplastic disease.
When the reason for an encounter is aftercare following a procedure or injury, the 2012 ICD-10-CM Official Guidelines and Reporting should be consulted to ensure that the correct code is assigned. Codes for reporting most types of aftercare are found in Chapter 21. However, aftercare related to injuries is reported with codes from Chapter 19, using seventh-character extensions to identify the service as aftercare.