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Hip Revision 21737 or 27134

  1. #1
    Location
    Charm City - Baltimore
    Posts
    103
    Default Hip Revision 21737 or 27134
    Medical Coding Books
    I have an unusual surgery that both the physician and I have questions on. The physician initially coded for 27137 (Revision, acetabular component only) but after some talking with other docs wondered if 27134 would be justifiable. I am uncertain.

    Physician performed:

    “massive revision of the left total hip using an acetabular cage, cadaveric implant, 36 mm eccentric cemented liner with a well-fixed AML stem, but the head was removed from the stem and replaced with a +11, 36 mm head. The cup and edges were packed with demineralized bone matrix and cancellous bone chips We placed 1 screw anteriorly, 6 screws superiorly and 4 screws in the flanges. The flanges were traced up. They lied completely on acetabular bone. There was no soft tissue between them. They were not at the sciatic notch area. They were directly over lateral acetabulum and pelvis.

    Do you know, if simply replacing the ball at the femoral head justifies 27134? Also are they any additional codes that could be used since so much work was done on the acetabular component (cage system)?

    Thank you for any feedback!
    Crystal, CPC, CCS-P

  2. #2
    Location
    San Antonio, Tx
    Posts
    73
    Default
    It does appear that the 2 components, acetabulum and femoral components, were worked on. Thus having met the 2 component requirement for 27134. I do not see any other additional codes that can be used.
    Ray Galvez CPC

  3. #3
    Location
    Charm City - Baltimore
    Posts
    103
    Default
    Thanks for your feedback! I also got the same answer from Margie Vaught.
    Crystal, CPC, CCS-P

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