A patient presented for total right hip arthroplasty using dual mobility components. The replacement was performed by placing a multi-hole acetabular shell and neutral dual mobility liner. A cemented femoral stem with collar was placed and a ceramic ball was then placed with a dual mobility bearing. The components included a metal cup and liner and the dual femoral head component consisted of a larger polyethylene head with a smaller ceramic ball within the larger head. What is the appropriate ICD-10-PCS code assignment for the dual mobility hip replacement?
Assign the following ICD-10-PCS code:
0SR9029 Replacement of right hip joint with metal on polyethylene synthetic substitute, cemented, open approach, for the total hip arthroplasty using dual mobility components.
The ICD-10-PCS device value specifies the outermost layer of the components corresponding to the joint surfaces being replaced by the joint prosthesis. Although ICD-10-PCS does not specifically capture dual mobility hip replacements, the codes capture the bearing surfaces where the two components meet. For hip replacements, the bearing surface is where the replacement femoral head meets the replacement acetabular cup; therefore, in this case, assign device value “2,” for metal on polyethylene.
Dual mobility implants provide an additional bearing surface compared to a traditional implant. With the dual mobility hip, a large polyethylene plastic head fits inside a polished metal hip socket component, and an additional smaller metal or ceramic head is snap-fit within the polyethylene head.