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Total hip replacement infection

  1. #1
    Question Total hip replacement infection
    Medical Coding Books
    I am not sure if I am correct on code selection on this one. The coding software I have shows the code we authed does not pair with the dx but the code I picked does. The doctor states he did an irrigation and debridement of the left hip post total hip arthroplasty (this is still in the global period). He re-incised previous incision saw that it went below the deep fascia and went completely down to the prosthesis. He irrigated with 9000 liters and scraped fibrinous tissue and exudate. Sent cultures. Which code is most appropriate--26991 or 27030? I am not sure because they are so similiar in there descriptions but since the doctor said he was doing and irrigation and debridement I feel I should bill that code even though it does not pair. Please help! Any advice would be appreciated. Thanks

  2. #2
    Boone, NC
    Since he went down completely to the prosthesis & irrigated I would go with 27030-78 (modifier if still in global from THA). Had he not gone down within the prosthesis I would've coded as 26990.

  3. Default
    from the coding software that we use (Ingenix Encoder Pro.), code 27030 links with diagnosis code 996.66. I tried linking code 26990, and it did link to a postoperative code (998.59), but i think you would have to add another code for the type of infection

  4. #4
    since he went down to the joint, I would use 27030-58. Code 26991 would be used if he only went down to the bursa.

  5. #5
    I wouldnt use the 58 modifier, since this an infection, the 78 is the most appropriate modifier for this scenario. I agree with the 27030-78

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