Removal of Hip Prosthesis


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My doctor wants to know how other coders would code for the following surgery. The codes I gave him were 27091 & 11981. He thinks since the spacer in this instance is actually more a prosthesis than just a spacer, we might be able to bill more and/or another or additional codes.

1. Rt hip explantation of femoral & acetabular components.
2. Irrigation & debridement & repair of ruptured fascia lata.
3. Implantation of antibiotic cement composite prosthesis.

Also, what about the fascia lata - is it included?
The debridement was the reaming of the canal of the femur & reaming the acetabulum-it appears this would be included (at least with 27091), according to AAOS. Any input on any/all of these questions will be much appreciated.
I agree with you --bill 27091 and 11981--the antibiotic spacer is not designed to last like a true prosthesis--so in my opinion it would be incorrect to bill a revision code--
Removal Infected Prosthesis

When a Physician goes in to remove and/or replace/revise an infected prosthesis - is the debridement of the infection as he/she goes in separately billable? Does it matter if it is an inpatient - in other words, would the debridement be reported using ICD-9 procedure codes in addition to the revision?

I agree with the 27091 however not so sure about the 11981 as I could be wrong but I thought that the spacer is already impregnated with the antibiotics, therefore the 11981 would be double dipping as the spacer is included in the code 27091 and 11981 states that the surgeon "inserts a cylinder".