AHA Coding Clinic® for ICD-9 - 2008 Issue 2; Ask the Editor
Total Hip Replacement Using Antibiotic Impregnated Cement
The patient developed an infection after a primary total hip replacement and was admitted to the hospital for surgical treatment. At surgery, the prosthesis was removed. An antibiotic impregnated methylmethacrylate cement spacer was inserted to fill the acetabulum. The patient was discharged on day 5 and placed on IV antibiotics for six weeks. Because the infection had resolved, the patient was readmitted at six weeks for removal of the antibiotic spacer and revision of the total hip replacement with insertion of a new hip prosthesis. The patient was discharged on day 4 and placed on intravenous (IV) antibiotics for six weeks. What are the appropriate code assignments for both inpatient admissions? For the second admission, would an aftercare code be appropriate, since the infected prosthesis had been removed? ...
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Article Overview
This premium article reviews a staged inpatient case involving infection after a hip replacement, removal of the prosthesis, placement of an antibiotic cement spacer, and later revision surgery. It is aimed at coding professionals who need to understand how the case is framed for diagnosis and procedure assignment across multiple admissions, including whether follow-up coding concepts are relevant on the second admission. The discussion is centered on inpatient coding interpretation, postoperative infection context, and the broader considerations that affect code selection.
Why This Topic Matters
Staged orthopedic infection cases can affect how admissions are classified and how follow-up care is represented in coding workflows. Understanding the article helps coders review multi-admission scenarios involving prosthetic joint infection, spacer placement, revision surgery, and aftercare considerations.
What You Will Learn
- How a staged hip replacement infection case is presented for coding review
- How multiple inpatient admissions may be considered in a prosthetic joint infection scenario
- What broad issues arise when evaluating follow-up coding concepts after removal of an infected prosthesis
- How inpatient orthopedic infection management is framed in a coding context
Who Should Read This
- Medical coders
- Coding auditors
- Inpatient coding professionals
- Orthopedic coding specialists
Codes Discussed
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