Patients and surgeons should select an implant that fits the following criteria:
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)
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…
What you can expect
CPT codes 00100-01860 specify “Anesthesia for” followed by a description of a surgical intervention. CPT codes 01916-01933 describe anesthesia for radiological procedures. Several CPT codes (01951-01999, excluding 01996) describe anesthesia services for burn excision/debridement, obstetrical, and other procedures.
Per the ASA CROSSWALK®, the anesthesia care may be best described with anesthesia CPT code 01402 - Anesthesia for open or surgical arthroscopic procedures on knee joint; total knee arthroplasty. Code 01402 has 7 base units.
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.
CPT CodesCodeDescription00470Anesthesia for partial rib resection; not otherwise specified00472Anesthesia for partial rib resection; thoracoplasty (any type)00474Anesthesia for partial rib resection; radical procedures (eg, pectus excavatum)00500Anesthesia for all procedures on esophagus230 more rows
ASA 3: A patient with a severe systemic disease that is not life-threatening.
There are three types of anesthesia: general, regional, and local. Sometimes, a patient gets more than one type of anesthesia. The type(s) of anesthesia used depends on the surgery or procedure being done and the age and medical conditions of the patient.
Coding for the hip replacement surgery is 27132.
The Current Procedural Terminology (CPT®) code 27132 as maintained by American Medical Association, is a medical procedural code under the range - Repair, Revision, and/or Reconstruction Procedures on the Pelvis and Hip Joint.
For a TKA revision (27486 Revision of total knee arthroplasty, with or without allograft; 1 component and 27487 Revision of total knee arthroplasty, with or without allograft; femoral and entire tibial component), watch for key words such as “removal and replacement of polyetheline liner” or “poly exchange,” and ...
CPT code 99151 is reported for the first 15 minutes of intraservice time for sedation services rendered to a patient younger than 5 years of age. CPT code 99152 is reported for the first 15 minutes of intraservice time for sedation services rendered to a patient age 5 years or older.
Modifiers are two-character indicators used to modify payment of a procedure code or otherwise identify the detail on a claim. Every anesthesia procedure billed to OWCP must include one of the following anesthesia modifiers: AA, QY, QK, AD, QX or QZ.
Anesthesia for Radiological ProceduresCPT® Code 01922 in section: Anesthesia for Radiological Procedures.
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.
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If the ICD-10-PCS Principal procedure code on Table 14.01a, the patient is in the 1st THKR Inpatient stratum and patient is eligible to be sampled for the 1st THKR Inpatient Stratum. Include the patient in the Initial Patient Population for the appropriate measures. Return to Clinical Data Processing Flow in the Data Processing section.
If the ICD-10-PCS Other procedure code is all missing or none on Table 14.05a, 14.06a, 14.07a, continue processing and proceed to ICD-10-CM Principal or Other Diagnosis Code Check.
In a total hip replacement (ICD-9-CM code 81.51) , the femoral head is removed and replaced with a metal stem, which is placed into the center of the femur, and a metal or ceramic ball. 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.
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.
A partial hip replacement is done mainly to repair fractured hips.
Common complications that may occur after a joint replacement surgery include venous thrombosis (category 453), pulmonary embolism (415.11), incision site infection (998.59), intraoperative fracture (998.89 plus an additional code to describe the type and site of the fracture), dislocation of prosthesis (996.42), loosening of prosthesis (996.41), breakage of prosthesis (996.43), periprosthetic fracture around prosthetic joint (996.44), change in leg length, joint stiffness, and daily wear and tear.
Replacement includes taking out the body part (eg, hip joint). According to the ICD-10-PCS Official Guidelines for Coding and Reporting, “Components of a procedure specified in the root operation definition and explanation are not coded separately. Procedural steps necessary to reach the operative site and close the operative site, including anastomosis of a tubular body part, are also not coded separately. Example: Resection of a joint as part of a joint replacement procedure is included in the root operation definition of Replacement and is not coded separately” (2013, page 5).