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Infection of Hip hemiarthroplasty

  1. Default Infection of Hip hemiarthroplasty
    Medical Coding Books
    I need help coding this surgery...

    Postop diagnosis: Infection of right hip, status post hip hemiarthroplasty

    Operation Procedures:
    1. Irrigation and debridement of right hip for infected total hip arthroplasty
    2. Exchange of head and bipolar components of right total hip arthroplasty

    Operative Procedure: (in part)

    We opened the previous incisional scar, there was no pus pocket, irrigated this out, cleaned it very thoroughly, debrided some of the necrotic fat as we saw it, took superficial cultures. Once we had gotten this done, we soaked some 4x4 with betadine and swabbed the wound, irrigated again and then took an 18 gauge spinal needle and introduced into the joint and sent it for aspirate, on it there was blood tinged fluid, but no evidence of purulence. I then opened the fascia, put Charnley retractor the capsule had been closed posteriorly. Dislocated the hip and took off the head in the bipolar. Irrigated copiously with saline, soaked in betadine solution 10ml and 250ml of saline for 3 minutes and then irrigated this out copiously. Again, there was no purulence in the joint. Then out back on the head in the bipolar and reduced the hip; closed the capsule posteriorly with multiple sutures.

    Any help would be greatly appreciated.

  2. #2
    Default
    Look to the 27134 area for the revision, I'm thinking the irrigation and debridement might be included.

  3. Default
    Look at 27030. I do not see where he exchanged any parts of the prosthesis. It reads that he put the original head back on the bipolar. So a revision would not apply.

  4. #4
    Default
    I agree with the 27030. You would report the revision code if the problem was due to a mechanical issue with the prosthesis.

  5. Default
    Thanks!!! This helps a ton!!

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