# Total hip replacement infection



## beck627 (Jun 26, 2007)

I am not sure if I am correct on code selection on this one. The coding software I have shows the code we authed does not pair with the dx but the code I picked does. The doctor states he did an irrigation and debridement of the left hip post total hip arthroplasty (this is still in the global period). He re-incised previous incision saw that it went below the deep fascia and went completely down to the prosthesis. He irrigated with 9000 liters and scraped fibrinous tissue and exudate. Sent cultures. Which code is most appropriate--26991 or 27030? I am not sure because they are so similiar in there descriptions but since the doctor said he was doing and irrigation and debridement I feel I should bill that code even though it does not pair. Please help! Any advice would be appreciated. Thanks


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## ls0403 (Jun 29, 2007)

Since he went down completely to the prosthesis & irrigated I would go with 27030-78 (modifier if still in global from THA).  Had he not gone down within the prosthesis I would've coded as 26990.


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## toosdi (Jul 18, 2007)

from the coding software that we use (Ingenix Encoder Pro.), code 27030 links with diagnosis code 996.66.  I tried linking code 26990, and it did link to a postoperative code (998.59), but i think you would have to add another code for the type of infection


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## swillard (Jul 18, 2008)

since he went down to the joint, I would use 27030-58.  Code 26991 would be used if he only went down to the bursa.


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## mbort (Jul 18, 2008)

I wouldnt use the 58 modifier, since this an infection, the 78 is the most appropriate modifier for this scenario.  I agree with the 27030-78


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## cwilson3333 (Sep 2, 2022)

beck627 said:


> I am not sure if I am correct on code selection on this one. The coding software I have shows the code we authed does not pair with the dx but the code I picked does. The doctor states he did an irrigation and debridement of the left hip post total hip arthroplasty (this is still in the global period). He re-incised previous incision saw that it went below the deep fascia and went completely down to the prosthesis. He irrigated with 9000 liters and scraped fibrinous tissue and exudate. Sent cultures. Which code is most appropriate--26991 or 27030? I am not sure because they are so similiar in there descriptions but since the doctor said he was doing and irrigation and debridement I feel I should bill that code even though it does not pair. Please help! Any advice would be appreciated. Thanks


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## cwilson3333 (Sep 2, 2022)

Just came across this thread in my research for some coding assistance on this *same procedure* that I am now trying to code.

Title of Procedure  is Irrigation and Debridement of Infected Total   [27030-78 is what I will be coding also]

I read that the Doctor also removed the femoral head and liner and replaced with new head and liner.  What should I code for this part of the procedure.

Thanks


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## amyjph (Sep 3, 2022)

27030. "Washout" of infected (or suspected infected) THA. The same is true for TKA and use of 27310 or shoulder 23040. Agree 78.

Re: cwilson question above - that turns into the same code 27030 the last I knew (for liner exchange only), but if doing the femoral head 27138 (femoral component, one operative session). If staged you would look at 27090 or 27091 for the hip, usually 27091.


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