Home Health ICD-9/ICD-10 Alert

Question: My patient had a complication of his knee replacement which was done in 2001. As a result, he went in for an elective total knee revision. Should I list V54.82 or V54.81 for this patient?

Answer: New as of Oct. 1, 2011, V54.82 (Aftercare following explantation of joint prosthesis) is intended to be used when a patient has had a joint prosthesis removed prior to joint replacement surgery. This code, along with another new code, V88.2x (Acquired absence of joint) specifies that a joint prosthesis was explanted to differentiate these patients from those who have one of "many other congenital and acquired causes of destruction of the hip or knee joint (including trauma, neoplasm, infection, etc)," according to the notes from the ICD-9-CM Coordination and Maintenance Committee's Sept. 15-16, 2010 meeting.

In your patient's case, V54.81 (Aftercare following joint replacement) is the appropriate aftercare code because the joint has already been replaced. You would list V54.82 if the patient currently had no joint prosthesis.

When listing V54.81, remember to also list a V43.6x (Joint replaced by other means) code to indicate which joint was replaced. In your patient's case, you would list V43.65 (Joint replaced by other means; knee).