Tips & Expertise: ICD-10-PCS for Replacement Procedures
by Kristi Pollard | Jul 21, 2020 | Blog, Webinar Q&As | 2 comments
Q: A patient with a previous hemiarthroplasty (say, right hip) comes in for a THR. Do you code the removal and replacement of the device (head/stem) and just replacement of the liner/cup?
A: When a patient presents to upgrade a right hemiarthroplasty to a total hip replacement (THR) implant, the procedure is reported with the following codes:
0SR90JZ, Replacement of Right Hip Joint with Synthetic Substitute, Open Approach
0SPR0JZ, Removal of Synthetic Substitute from Right Hip Joint, Femoral Surface, Open Approach
The body part for the THR is right hip since both joint surfaces were replaced. The body part for removal of the hemiarthroplasty implant is femoral surface of the hip.
Q: How do you code polyethylene exchange of the left total knee. They took out the old one and placed a new one.
A: Exchange of a tibial liner of the left knee is reported with two codes: one for removal of the old liner and one for the placement of the new liner. Placement of a new liner is reported with the root operation Supplement, so the codes for exchanging a left knee liner are:
0SUD09Z, Supplement Left Knee Joint with Liner, Open Approach
0SPD09Z, Removal of Liner from Left Knee Joint, Open Approach
**The coding information and guidance in this post is valid at the time of publishing. Readers are encouraged to research subsequent official guidance in the areas associated with the topic as they can change rapidly.
Kristi is a senior consultant with more than 25 years of industry experience; she is responsible for the development of web-based, instructor-led, and webinar training materials; conducting training in ICD-10-CM/PCS and CPT; and performing DRG and APC audits. Kristi has an extensive background in coding education and consulting and is a national speaker and published writer on topics related to ICD-10 and CPT coding and code-based reimbursement. She has designed and developed training programs for inpatient and outpatient hospital-based coding, with a focus on vascular interventional radiology, interventional cardiology, orthopedics, and obstetrics.
Kristi has served the Colorado Health Information Management Association (CHIMA) as board Director, co-chair of the Data Quality Committee, and co-chair for the ICD-10 Task Force. She is also a past president of the Northern Colorado Health Information Management Association (NCHIMA). Kristi is the proud recipient of the 2011 AHIMA Triumph Award for Mentoring for her voluntary work as the "Coder Coach." She has also received awards from CHIMA for Distinguished Member (2018) and Outstanding Volunteer (2013) and from AHIMA for Roundtable Achievement in Coding Excellence (RACE).
Jennifer Martinez on January 12, 2022 at 6:19 am
What would be the ICD-10 aftercare code for this procedure? We are researching the Z47.3_ or just use the Z47.1 for the aftercare.
kkluglein on January 12, 2022 at 10:32 am
Hi Jennifer – What procedure are you referring to? The difference between the codes is: Z47.1 is used to report aftercare, such as physical therapy, once a patient has had joint replacement surgery. The codes in subcategory Z47.3 is used for aftercare after a joint replacement prosthesis has been removed. The most likely scenario for reporting this code would be a patient presenting for removal of an antibiotic spacer and placement of a new joint replacement prosthesis. Thank you!