AHA Coding Clinic® for ICD-10-CM and ICD-10-PCS - 2018 Issue 2; Ask the Editor
Exchange of Tibial Polyethylene Component with Stabilizing Insert (Tibial Tray)
The patient presented with an infected internal left knee joint prosthesis and underwent arthrotomy of left knee, tricompartmental synovectomy, and tibial polyethylene component exchange with anterior stabilizing insert. The existing polyethylene tibial component was removed. Posterior compartment synovectomy was performed, and a larger polyethylene tibial component with anterior stabilization (tibial tray) insert was implanted. According to research, a mobile bearing knee (rotating platform knee) indicates that the polyethylene liner is not fixed but is free to rotate on a smooth tibial tray. The ICD-10-PCS does not provide a device value for tibial tray. Would it be appropriate to use the root operation “Supplement” along with the device value “Liner”? Coding Clinic Fourth Quarter 2016, pages 111-112 advised to use the root operation “Supplement” for the replacement of a hip joint liner. What are the correct ICD-10-PCS codes for this case? ...
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Article Overview
This article discusses a knee prosthesis revision scenario involving exchange of a tibial polyethylene component with a stabilizing insert and the related ICD-10-PCS device-value issue. It is aimed at coders and coding professionals who need to understand how this type of orthopedic prosthesis case is discussed in coding guidance and how the article frames the coding question in relation to official references.
Why This Topic Matters
Knee prosthesis revisions and component exchanges can be difficult to classify consistently, especially when device terminology in operative reports does not align neatly with available ICD-10-PCS values. This topic matters to coding staff, auditors, and CDI professionals working with orthopedic inpatient procedures and official coding guidance.
What You Will Learn
- The procedural context of a tibial polyethylene component exchange in a knee prosthesis case.
- How the article frames the ICD-10-PCS device-value issue for this orthopedic scenario.
- What official coding guidance reference is discussed in relation to the case.
- The general coding relevance of rotating platform knee terminology.
Who Should Read This
- Inpatient coders
- Hospital coding staff
- Clinical documentation integrity professionals
- Coding auditors
- Orthopedic surgery coding specialists
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