Risks associated with hip replacement surgery can include:
procedure code and description 27130- Arthroplasty, acetabular and proximal femoral prosthetic replacement (total hip arthroplasty), with or without autograft or allograft - average fee payment - $1510 -$1520 27445 Arthroplasty, knee, hinge prosthesis (e.g., Walldius type) 27446 Arthroplasty, knee, condyle and plateau; medial OR lateral compartment 27447 ARTHROPLASTY, KNEE, CONDYLE…
Identify the episode trigger
Presence of right artificial hip joint The 2022 edition of ICD-10-CM Z96. 641 became effective on October 1, 2021. This is the American ICD-10-CM version of Z96.
642.
**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
Presence of left artificial hip joint642 Presence of left artificial hip joint.
For example, a patient with severe osteoarthritis of the hip has a total hip arthroplasty. The surgeon reports CPT code 27130.
In a total hip replacement (also called total hip arthroplasty), the damaged bone and cartilage is removed and replaced with prosthetic components. The damaged femoral head is removed and replaced with a metal stem that is placed into the hollow center of the femur.
Current Procedural Terminology (CPT) codes For this study, CPT 27130 was used to identify primary THA, while CPT 27132 was used to identify conversion THA.
M25. 551 Pain in right hip - ICD-10-CM Diagnosis Codes.
Arthroplasty is a surgical procedure to restore the function of a joint. A joint can be restored by resurfacing the bones. An artificial joint (called a prosthesis) may also be used.
A partial hip replacement is done mainly to repair fractured hips.
Hip replacement surgery involves removing the diseased hip joint and replacing it with artificial prosthetic components. Conditions that may damage the hip, necessitating a hip replacement, include osteoarthritis, rheumatoid arthritis, posttraumatic arthritis, hip fracture, avascular necrosis/osteonecrosis, a bone tumor, and childhood hip disease.
The typical life span of a hip prosthesis is 10 to 15 years.
The “socket” part of the acetabulum is removed and replaced with a metal socket. A plastic, ceramic, or metal spacer (also called a liner or insert) is placed between the new femoral head and socket to allow for a smooth surface. Physicians often use the terms “arthroplasty” and “replacement” interchangeably.
Hip replacement, also referred to as total hip arthroplasty, is a surgical procedure to replace an unhealthy hip joint with an artificial joint. Hip replacement surgery aims to relieve pain and restore the alignment and function of a diseased hip joint after conservative treatment options have failed.
In a total hip replacement, 27130 Arthroplasty, acetabular and proximal femoral prosthetic replacement (total hip arthroplasty), with or without autograft or allograft, the damaged bone and cartilage are removed and replaced with prosthetic components, which come in many different materials and designs. The femur is first hollowed out and the femoral head removed. A metal stem is then cemented or “press fit” directly into the hollowed-out femur. A metal or ceramic ball or “head” is placed on top of the stem to replace the damaged femoral head that was removed. The surface of the acetabulum is then reamed out and inserted with a metal socket, or “cup.” Screws or cement secure the socket in place. A spacer, sometimes called a “liner,” is inserted between the new ball and socket to create a smooth surface for the new joint to glide.#N#Although hip replacements relieve pain and restore the function of a hip joint, they do not last forever. A successful hip prosthesis typically lasts about 15 years, and some patients need one or more revisions of a hip replacement in their lifetime, particularly if:
Conditions that damage the hip, necessitating a hip replacement, include arthritis, fracture, avascular necrosis, bone tumors or cysts, and hip dysplasia. The implant fits into the hip.
The most common reasons for a hip revision are recurrent dislocation of the prosthetic joint, infection, and mechanical failure. Mechanical failure consists of normal wear and tear or breakage of the prosthesis.
If an infection following a hip replacement develops, treatment typically includes surgery or multiple surgeries and antibiotics. Sometimes the surgeon performs a thorough debridement of the bone to clean out the infection, coded with 27030 Arthrotomy, hip, with drainage (eg, infection). If the surgeon debrides only tissue and/or muscle but not bone, look to debridement codes 11040-11043.#N#To prevent further infection, the surgeon might replace part of a hip replacement component, such as the polyethylene liner and/or the prosthetic head, coded with 27137 Revision of total hip arthroplasty; acetabular component only, with or without autograft or allograft and modifier 52 Reduced services. (Modifier 52 indicates the full description of the given code was not performed, as only part of the hip replacement component is exchanged. It may be necessary to include a copy of the operative report with the claim submission when using modifier 52.)#N#Another surgical treatment for infection following a hip replacement is a complete exchange of prosthetic joint, done in two (or more) operative sessions. The first stage involves complete removal of the hip replacement, debridement and cleaning of the bone, and implantation of a temporary cement spacer. The first stage of surgery is coded with 27091 Removal of hip prosthesis; complicated, including total hip prosthesis, methylmethacrylate with or without insertion of spacer. If the temporary spacer delivers antibiotics to the hip area, you may also report 11981 Insertion, non-biodegradable drug delivery implant.#N#During the next surgery, which usually occurs six weeks later, the physician removes the temporary spacer and implants new total hip replacement components. Report this surgery with 27132 Conversion of previous hip surgery to total hip arthroplasty, with or without autograft or allograft. Do not report revision code 27134 unless both the removal and exchange of the hip replacement component (s) occur during the same operative session.#N#Reporting a conversion code means the patient had a previous open hip surgery and the area being operated on is altered in some way. The value of the conversion code reflects the additional complexity compared to a primary arthroplasty procedure. Use the conversion code when the patient has had a prior open procedure, such as a hemiarthroplasty, open reduction and internal fixation (ORIF), or arthroscopy, and subsequently undergoes a total hip replacement.#N#Example: A patient had a hip arthroscopy as a teenager and years later presents for a total hip replacement surgery due to severe osteoarthritis. Coding for the hip replacement surgery is 27132.