AHA Coding Clinic® for ICD-10-CM and ICD-10-PCS - 2016 Issue 3; Ask the Editor
Use of Cemented Versus Uncemented Qualifier for Joint Replacement
For reporting knee and hip joint replacement procedures, ICD-10-PCS provides three values for the 7th character qualifier: “9,” Cemented, “A,” Uncemented, and “Z,” No qualifier. Most often the physician will document “cemented” when it is used, but typically does not document “uncemented.” For example, a patient with failed right total hip replacement presents for revision. The femoral stem and liner are replaced; however, it is not clear whether the implant used was “cemented or uncemented.” What is the appropriate qualifier value “Z” or “A”? ...
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Article Overview
This article addresses a focused ICD-10-PCS coding question for hip and knee arthroplasty reporting. It discusses how documentation is reviewed when cementation status is unclear, and it is intended for coders and revenue cycle staff who work with joint replacement procedure coding and documentation review.
Why This Topic Matters
Accurate qualifier selection is important for procedure coding integrity when the operative record does not explicitly state whether a prosthesis was cemented or uncemented. The article helps readers understand the documentation issues that affect reporting for these joint replacement cases.
Article Sections
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Qualifier values for hip and knee joint replacement
Introduces the ICD-10-PCS qualifier values used in reporting hip and knee joint replacement procedures and frames the documentation issue addressed by the article.
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Documentation review when cementation status is unclear
Discusses the type of record review involved when the operative documentation does not clearly identify the prosthesis type. The section centers on how unresolved documentation affects qualifier selection.
What You Will Learn
- How the article frames ICD-10-PCS qualifier reporting for joint replacement procedures.
- What documentation issue is addressed when cementation status is not clearly stated.
- Which kinds of records are relevant to determining the appropriate qualifier.
- How the topic applies to hip and knee arthroplasty coding review.
Who Should Read This
- Medical coders
- Coding auditors
- Revenue cycle staff
- Health information management professionals
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