Periprosthtic fracture left femur

cwilson3333

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Patient with total hip arthroplasty, fell and has trochanteric fracture left hip [periprosthetic] Comminuted

Title of Procedure: Revision hip arthroplasty with trochanteric fixation of left hip

Brief description
Both components were replaced
Attempt was made to fix fracture of trochanteric, with wire and cable, but cable cut through bone [Bone quality not great]
Fixation was then done with 5-0 Ethibond, which provided trochanteric stability after hip components were replaced.

Revision Procedure 27134

Not sure what to use for fracture fixation [which was the result of the fall] ?

Would appreciate some guidance on this coding
And hope this brief note is explanatory
 

amyjph

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I am not sure you can report that separately with the 27134. Is it the greater trochanter? If so look at 27248, however, it hits NCCI edits. (Depending on payer). Also, it says attempt was made but the bone quality was not good so they couldn't use a wire & cable so it appears from the note above it was stabilized as part oft he hip revision...(?). If there is more to the note that may change things but it doesn't seem like it. If you read the 27134 it includes trochanteric osteotomy and repair as part of it, and in this case it is fractured but it's still in the same area so in my opinion, would not report separately. Also, consult the AAOS Global Service Data books.

I have coded fractures lower down on the shaft and knee areas at the same time as hip work for different type traumatic injuries separately in the past.
 

cwilson3333

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Body of operative note says the lesser trochanter was fractured and the greater trochanter had a fracture through it down at the base of the fracture.
The lesser trochangter was comminuted, and throughout the procedure, became more comminuted.

Thanks for you input, Amy
 
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