The patient is an 81-year-old female with marked degenerative arthritis of the right knee, who underwent a right total knee replacement with revision of the right femoral component during the same operative episode. Initially the surgeon carried out a total knee replacement, but was not happy with the results and then revised the right femoral component during the same operative episode. In ICD-9-CM would this be coded using procedure code 81.54 only or both procedure codes 81.54 and 00.82?
Code the surgery as a total knee replacement. Assign only code 81.54, Total knee replacement. The surgeon implanted a total knee prosthesis and discovered the femoral component was not aligned properly. He then removed and revised the component and reimplanted the prosthesis back into the patient. Do not assign a code for revision of knee replacement, since this was the initial knee replacement.