AHA Coding Clinic® for ICD-10-CM and ICD-10-PCS - 2015 Issue 3; Ask the Editor
Total Hip Replacement with Acetabular Reconstruction
A patient with metastatic bone cancer of the left hip is admitted to undergo acetabular reconstruction with hip replacement. At surgery the proximal femur was prepared using sequential reamers and broaches to accept the cemented Stryker femoral stem. The acetabulum was prepared and a 60 gap cage was placed and multiple screws were placed for fixation. Bone cement was used to fill the lesion and around the screws and to cement the tripolar acetabular insert. The Stryker femoral stem was also cemented into place. The neural head was impacted into the femur and the hip was carefully reduced. What is/are the appropriate ICD-10-PCS code(s) for acetabular reconstruction and a total hip arthroplasty performed during the same operative episode? ...
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Article Overview
This premium article explains how to approach ICD-10-PCS reporting for a complex hip operative episode involving acetabular reconstruction and total hip replacement during the same surgery. It is relevant to inpatient coders, CDI specialists, orthopaedic coding staff, and others who work with implant-based musculoskeletal procedures. The article focuses on procedure identification, operative sequencing, and how the described surgical work is translated into ICD-10-PCS code selection.
Why This Topic Matters
Complex hip reconstruction cases can involve more than one reportable procedure in the same operative session. Understanding how the procedure elements are separated for ICD-10-PCS reporting helps support accurate inpatient coding for musculoskeletal surgery.
What You Will Learn
- How the article frames a combined hip reconstruction and replacement case for ICD-10-PCS reporting.
- How complex operative episodes in orthopaedic surgery may require more than one procedure code.
- What broad operative details are considered when distinguishing reconstruction from arthroplasty in inpatient coding.
- The general type of coding guidance provided for a hip surgery case with major bone loss.
Who Should Read This
- Inpatient medical coders
- Orthopaedic coding specialists
- CDI professionals
- Coding educators
- Health information management staff
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