Wiki ankle revision

[jacksons7@upmc.edu]

if anyone can help on this one, I have an issue, a failed ankle arthroplasty was done, with removal of the hardware and an anti biotic spacer implanted, six weeks later, the spacer was removed and a revision was done, my thoughts are the first surgery should be just 27704 for removal of the implant, the second would be 27703 and another 27704 for removal of the spacer and the revision. Any thoughts?

 

[amyjph]

I would say that the removal of implant & implantation of the spacer would be coded: 27704/1198.
For the next surgery 6 weeks later, the removal of the spacer would be: 11982, you wouldn't use 27704 because the implant was already removed previously. I don't know that I would use 27703 because that is revising a component but the components were already taken out in the prior surgery. You may have to report 27702. I would follow the same logic as we use for reporting TKA revisions that are staged. See the AAOS guidance below:

http://www.aaos.org/news/bulletin/sep07/managing1.asp