Hello, I have been coding for Ortho for awhile now but I'm unsure of what code to use in this surgery. I thought 27138 at first because of the femoral component but if the acetabular liner is also being exchanged, does that make it 27134-52? Any help and tips would be greatly appreciated. Thank you!
Procedure:
Left hip revision arthroplasty exchange femoral head for a +7.5 mm offset 36 mm diameter ceramic head, and exchange acetabular liner to a 36 mm diameter X3 polyliner by Stryker.
The patient consented to left hip revision arthroplasty polyethylene exchange. Informed consent was documented in the chart. The patient and surgeon marked the left hip. The patient understood the risks and benefits of the procedure which were documented in the chart. The patient understood the importance of appropriate arthroplasty congruency to correct for a 32 mm liner errantly placed instead of a 36 mm liner for a 36 mm diameter ceramic head.
The patient was appropriately sedated by the part of anesthesia, the left hip was prepped and draped in the usual sterile orthopedic fashion. A formal timeout was made to confirm the surgical site, information, and procedure. The patient had received Ancef IV infusion as documented in the chart prior to incision.
Next 15 blade scalpel was used to incise the Monocryl running suture and 2-0 Vicryl subcutaneous sutures which were removed carefully. Next the #1 Vicryl running suture was removed from the fascia that enclosed sartorius and tensor fascia lata interval. The wound was copiously irrigated with sterile saline using a pulse lavage. Next the hip was dislocated and the femoral head and acetabular liner removed. The acetabular shell and Accolade 2 stem were very stable and unchanged in alignment and positioning. A +7.5 mm offset 36 mm diameter ceramic head was impacted in the stem, and a 36 mm diameter X3 acetabular polyethylene liner was also positioned appropriately. The hip was then reduced and trialed with range of motion revealing a very stable presentation. Intraoperative C-arm fluoroscopy confirmed excellent positioning of the implant alignment. The wound was again copiously irrigated with sterile saline with a pulse lavage, and was closed in layers using #1 Vicryl for the fascia surrounding the tensor fascia and sartorius interval, 2-0 subcutaneous Vicryl and 4-0 running Monocryl suture followed by Dermabond adhesive dressing for the skin. No drain was required as the patient had no new bleeding and tolerated the procedure well. A sterile dressing was applied and the patient was awakened from anesthesia and discharged to the postoperative care unit in stable condition and tolerated the procedure well.
Procedure:
Left hip revision arthroplasty exchange femoral head for a +7.5 mm offset 36 mm diameter ceramic head, and exchange acetabular liner to a 36 mm diameter X3 polyliner by Stryker.
The patient consented to left hip revision arthroplasty polyethylene exchange. Informed consent was documented in the chart. The patient and surgeon marked the left hip. The patient understood the risks and benefits of the procedure which were documented in the chart. The patient understood the importance of appropriate arthroplasty congruency to correct for a 32 mm liner errantly placed instead of a 36 mm liner for a 36 mm diameter ceramic head.
The patient was appropriately sedated by the part of anesthesia, the left hip was prepped and draped in the usual sterile orthopedic fashion. A formal timeout was made to confirm the surgical site, information, and procedure. The patient had received Ancef IV infusion as documented in the chart prior to incision.
Next 15 blade scalpel was used to incise the Monocryl running suture and 2-0 Vicryl subcutaneous sutures which were removed carefully. Next the #1 Vicryl running suture was removed from the fascia that enclosed sartorius and tensor fascia lata interval. The wound was copiously irrigated with sterile saline using a pulse lavage. Next the hip was dislocated and the femoral head and acetabular liner removed. The acetabular shell and Accolade 2 stem were very stable and unchanged in alignment and positioning. A +7.5 mm offset 36 mm diameter ceramic head was impacted in the stem, and a 36 mm diameter X3 acetabular polyethylene liner was also positioned appropriately. The hip was then reduced and trialed with range of motion revealing a very stable presentation. Intraoperative C-arm fluoroscopy confirmed excellent positioning of the implant alignment. The wound was again copiously irrigated with sterile saline with a pulse lavage, and was closed in layers using #1 Vicryl for the fascia surrounding the tensor fascia and sartorius interval, 2-0 subcutaneous Vicryl and 4-0 running Monocryl suture followed by Dermabond adhesive dressing for the skin. No drain was required as the patient had no new bleeding and tolerated the procedure well. A sterile dressing was applied and the patient was awakened from anesthesia and discharged to the postoperative care unit in stable condition and tolerated the procedure well.