A patient, who is status post left total knee arthroplasty surgery, and recent wisdom tooth extraction, is diagnosed with hematogenous left knee prosthetic joint infection. He underwent revision of the arthroplasty with exchange of modular components and synovectomy. Does the term “hematogenous” mean the prosthetic joint infection is due to the presence of the prosthesis, or instead is seeded from concurrent infection elsewhere in the body? Is it appropriate to assign code T84.54XA, Infection and inflammatory reaction due to internal left knee prosthesis, initial encounter, for the hematogenous left prosthetic knee joint infection due to the dental infection?
No. In this case, the infection of the knee is not due to the prosthetic joint, but occurred secondary to another source. Hematogenous infection by definition means the infection originated in the blood and spread by way of the bloodstream. Assign code M00.862, Arthritis due to other bacteria, left knee, for the hematogenous infection caused by the dental infection. Assign also code Z96.652, Presence of left artificial knee joint. Additional codes should be assigned for any other associated infections as well as a code for the specific bacterial organism. In this case, a complication code is not appropriate, as the infection is not due to the prosthesis.