A patient diagnosed with “right elbow terrible triad” had a radial head arthroplasty and lateral collateral ligament repair. At surgery, the surgeon opened the joint, revealing a subluxed radial head that was comminuted and not repairable. The subluxed radial head was cut at its neck, and removed. The radial head was then replaced with a prosthetic implant. In Coding Clinic, Third Quarter 2015, “Shoulder Joint” was assigned as the body part value for a patient who underwent removal of the articular head surface during a shoulder joint replacement. Would that advice be unique to the shoulder, or could the logic be applied to the elbow joint as well? What is the appropriate body part value for the radial head arthroplasty?
Assign the following ICD-10-PCS code:
0PRH0JZ Replacement of right radius with synthetic substitute, open approach for the right radial head arthroplasty
Radial head arthroplasty is typically performed for severe fractures or in older patients with poor bone quality. It is common to replace only the radial head bone, especially for fractures. Radial head replacement surgery involves resecting damaged bone and replacing the radial head with a prosthesis. Radial head arthroplasty and total elbow replacement surgery are different, and the ICD-10-PCS did not previously distinguish between the different elbow joint portions being replaced. Effective October 1, 2018, the following entries were added to the ICD-10-PCS Index: