Wiki Peri-prosthetic fx

[jmkitchen]

I'm stumped! Pt. suffered a peri-prosthetic femur fx. Dr. replaced the femoral stem - no problem - CPT-27138. However, he extended the incision, reduced the fracture and held with standard reduction clamps while three Synthes cables were applied. What CPT should I use for the fx repair??

 

[JMeggett]

Check out 27236. The Coding Companion Book I have gives this explanation: "The Physician directly exposes the femoral fracture for treatment. The patient is placed in a supine position or slightly rolled up onto the other side. A 15 cm incision is made over the lateral hip. The fascia lata is split and the vastus lateralis muscle is detached from the femur. The physician exposes the femoral neck and head. A small periosteal elevator or Kirschner wire is used to reduce (reposition) the fracture. The physician places guide pins through the bone and across the fracture. The guide pins help determine correct screw length. The physician may use cannulated screws or compression hip screws and a plate to achieve internal fixation. In some cases due to the risk of subsequent non-union or avascular necrosis, the physician may replace the femoral head with a femoral prosthesis. The femoral canal is reamed out. A prosthesis of the proper size and length is selected and inserted into the femoral canal. The physican reduces the prothesis into the acetabulum. The incision is repaired in layers with sutures, staples, and/or Steri-strips."
Jenna