Home Health ICD-9/ICD-10 Alert

Welcome more specific coding for joint prosthesis explantation.

Confused about when it's appropriate to list V54.82 (Aftercare following explantation of joint prosthesis)? The AHA Coding Clinic for ICD-9-CM 4th quarter, 2011 has some answers. This code is intended for use when patients are receiving aftercare following the removal of joint prosthesis. Such aftercare includes "encounters for joint replacement insertion surgery where it was necessary to stage the procedure or for joint prosthesis insertion following a prior explantation of the prosthesis."

There are situations when an existing joint prosthesis must be removed as the result of an infection or some other problem, but it's not possible to replace the prosthesis at the same encounter, Coding Clinic explains. Such circumstances require a return encounter to insert a new prosthesis. In these cases, list V54.82 along with the appropriate code from subcategory V88.2x (Acquired absence of joint) to specifically identify the joint.

The new issue of Coding Clinic also offers advice about when to list V88.21 (Acquired absence of hip joint), V88.22 (Acquired absence of knee joint), and V88.29 (Acquired absence of other joint). These status codes indicate an acquired absence of a joint which may include joint prosthesis explanation.

Try this: Assign one of the V88.2x codes when a patient is awaiting implantation of a joint prosthesis, Coding Clinic advises. So, you'll list one of these codes when your patient's prosthesis has been removed to allow an infection to heal and the patient is admitted before completing the joint replacement procedure.

Before the creation of the V88.2x codes, you would code for these patients with for an acquired deformity of the site. "However, this did not accurately describe the nature of the acquired deformity," Coding Clinic says. Subcategory V88.2.x, indicates that the patient has had a prosthesis explanted and may be used even when the current encounter is unrelated to implantation of a new prosthesis.