August 30, 2010 Coding for Joint Replacement For The Record Vol. 22 No. 16 P. 28

Joint instead of surgery involves removing a hurt joint and replacing it through an artificial prosthetic joint with the score of relieving pain and increasing mobility and also function. The hip and also knee joints most frequently require replacement.

Total hip instead of is classified to password 81.51, and partial hip instead of goes to password 81.52. A full hip replacement requires replacing the femoral head and the acetabular articular surface. A partial i know well replacement, additionally documented as hemiarthroplasty, entails replacing only the femoral head. A bipolar hemiarthroplasty is a specific kind of hemiarthroplasty in which a femoral prosthesis is used with one articulating acetabular component, but the acetabular cartilage is not replaced.

Revision of a i know well joint will go come a different selection of codes. Follow to Coding Clinic, “Any time the share is replaced or revised after the early replacement would be considered a revision” (AHA Coding Clinic because that ICD-9-CM, 2nd quarter 1996, web page 13). The codes because that revision the hip materials include the following:

• 00.70, review of i know well replacement, both acetabular and also femoral components;

• 00.71, review of i know good replacement, acetabular component;

• 00.72, review of i know well replacement, femoral component;

• 00.73, revision of hip replacement, acetabular liner and/or femoral head only; and

• 81.53, review of hip replacement, not otherwise specified.

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Code 81.53 is assigned just if a revision of hip instead of is performed but is not specified regarding component(s) replaced.

Coding directives also state come assign second code because that any type of bearing surface ar if known, which has the following:

• 00.74, i know good bearing surface, metal-on-polyethylene;

• 00.75, hip bearing surface, metal-on-metal;

• 00.76, i know good bearing surface, ceramic-on-ceramic; and

• 00.77, hip bearing surface, ceramic-on-polyethylene.

Total knee instead of is share to code 81.54 and involves replacing the articular surfaces of the femoral condyles, tibial plateau, and also patella. Password 81.54 additionally includes bicompartmental knee replacement, partial knee replacement, tricompartmental knee replacement, and unicompartmental (hemijoint) knee replacement.

The codes for revision that knee components include the following:

• 00.80, revision of knee replacement, complete (all components);

• 00.81, revision of knee replacement, tibial component;

• 00.82, review of knee replacement, femoral component;

• 00.83, review of knee replacement, patellar component;

• 00.84, review of full knee replacement, tibial insert (liner); and

• 81.55, revision of knee replacement, no otherwise specified.

Code 81.55 is assigned only if a review of a knee replacement is performed however is not specified as to the component(s) replaced. There is an instructional keep in mind under subcategory 00.8 stating, “Report up to two contents using 00.81-00.83 to define revision the knee replacements. If all three contents are revised, report 00.80.” In various other words, if the tibial and femoral components are revised, assign both password 00.81 and code 00.82.

Code assignment for other joint instead of surgeries include the following:

• 81.56, total ankle replacement;

• 81.57, replacement of share of foot and also toe;

• 81.59, revision of joint replacement of reduced extremity, not somewhere else classified;

• 81.80, complete shoulder replacement;

• 81.81, Partial shoulder replacement;

• 81.88, Reverse full should replacement (new code efficient October 1);

• 81.84, full elbow replacement;

• 81.73, full or partial wrist replacement; and

• 81.97, review of shoulder, elbow, or wrist replacement.

Physicians regularly use the terms “arthroplasty” and also “replacement” interchangeably. Arthroplasty is characterized as a joint repair. Over there are various ICD-9-CM codes because that arthroplasty if only a share repair is performed. To differentiate whether one arthroplasty is important a share replacement, look because that a prosthetic implant. Evaluation the operative report completely for proper code assignment.

Common complications that may take place after a joint-replacement surgery include venous thrombosis (category 453), pulmonary embolism (415.11), incision site infection (998.59), intraoperative fracture (998.89), dislocation of prosthesis (996.42), loosening of prosthesis (996.41), breakage of prosthesis (996.43), periprosthetic fracture around prosthetic joint (996.44), readjust in foot length, joint stiffness, and/or day-to-day wear and also tear.

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Coding and also sequencing for joint replacement room dependent on the physician documentation in the clinical record and application that the official Coding Guidelines for inpatient care. Also, use details AHA Coding Clinic for ICD-9-CM and American medical Association CPT Assistant referrals to certain complete and also accurate coding. — This info was all set by Audrey Howard, RHIA, that 3M Consulting Services. 3M Consulting services is a service of 3M wellness Information Systems, a caterer of coding and also classification systems to more than 5,000 health care providers. The firm and that representatives perform not assume any kind of responsibility for reimbursement decision or insurance claims denials do by service providers or payers together the an outcome of the misuse of this coding information. Much more information around 3M health and wellness Information equipment is obtainable at www.3mhis.com or by call 800-367-2447.