Diagnosis for Total Hip Revison after removal of Implants

Lynnh

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I have a patient scheduled for a Total Hip Revision (27134) She had a fracture (S72.041A) that was treated with Hemiarthroplasty. She developed an infection and the implants were removed and antibiotic spacers were placed. She is now clear of infection and is ready for revision. What diagnosis would I use for the Revision? Thank you.
 

mitchellde

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The hip fracture was initially successfully treated. Then the patient developed on infection due to the implant which was initially treated with removal, so now the complication of the infection is being subsequently treated wit a revision. That is how I would code it.. The T code for complication due to infection of he implant with the 7th character D, you could successfully argue for the A and I would accept that as well.
 

sxcoder1

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I've read that it would be inappropriate to use the infection T code for the 2nd surgery because the infected prosthesis has been removed.
 

mitchellde

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However the complication due the infection is still present until the parent is put back to whole. The infection was due to the implant, and yes that has been removed, however the patient is not in the same status as before the infection therefore this is all still related not to the fracture but due to the complication.
 
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Quezon City, MM
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infection

You could use the T84.5- with 7th character A, the active treatment for this case is this "implants were removed and antibiotic spacers were placed.", the implant was removed because it was infected and not because the fracture has healed or recovering and the physicians way of curing the infection is by putting a new prosthesis the antibiotic spacer (the active treatment)
 
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