Wiki Shoulder spacer removal and replacement

[jvanek82]

The surgeon is doing a spacer exchange. He is removing a humeral shoulder spacer from a patient that still has an infection. He cleans out the humeral canal of residual cement and tissue and then reinserts an antibiotic spacer that he manually prepared with cement and antibiotics. He is calling the procedure "left shoulder replacement with removal of an antibiotic spacer debridement and placement of a new hemiarthroplasty spacer". How can I code this? The work involved just seems more extensive than just billing 11983, but I am not sure if 23334 would be what he did with the removal of the spacer.

Any suggestions will be appreciated!

Thanks!
Jodi

 

[NRaizman]

You need a primary debridement code from the 11xxx line typically.

Then code +20705 for removal of the old spacer and +20704 for insertion of the new spacer.

You can’t code hemiarthroplasty or revision TSA for spacer exchange like this.

 

[jvanek82]

You need a primary debridement code from the 11xxx line typically.

Then code +20705 for removal of the old spacer and +20704 for insertion of the new spacer.

You can’t code hemiarthroplasty or revision TSA for spacer exchange like this.

Thank you! That makes sense and I was pretty sure you couldn't use the TSA revision codes! However, the debridement codes are not listed under 20705/20704 as primary codes. Searching for a primary code, I see 23040 is in the list so I will try using that code.