Orthopedic Coding Alert

Question: Our surgeon did a debridement and removal of arthroplasty in a patient who was diagnosed with severe deep infection of the right total hip prosthesis. The Prostalac® acetabular prosthesis was placed with antibiotic augmentation. What is the best code we can report for the Prostalac® acetabular component placement?

Iowa Subscriber

Answer: This is essentially a two stage procedure. First, your surgeon is removing the prosthesis. Secondly, your surgeon is inserting the Prostalac® device which is an articulating cement spacer. You report code 27091 (Removal of hip prosthesis; complicated, including total hip prosthesis, methylmethacrylate with or without insertion of spacer) and 11981 (Insertion, non-biodegradable drug delivery implant).

You may also report the ICD codes 80.05 (Arthrotomy for removal of prosthesis without replacement, hip) and code 84.56 (Insertion or replacement of [cement] spacer) to report the two steps. Your surgeon may plan a second surgery to place a total hip prosthesis.