Wiki Placement of articulating spacer after removal of prothesis

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bostonmom

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Patient had a total hip placed a year ago. Now has an infection, surgeon is removing the total hip and is placing an articulating spacer. I want to code the surgery as 27091 but the surgeon is insisting on 27134. The surgeon is also stating that the next surgery in a few months will be 27134 again, when he removes the articulating spacer and places a total hip. In my opinion the second surgery should then be 27132 since the previous components were removed before the articulating spacer was placed. Thoughts?
 
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Your surgeon is correct - this is coded as 27134 for an articulating spacer. If it is a static spacer, then 27091 would be correct.
This is has been noted in CPT-Assistant and also AAOSNow as the position of both AAOS and KZA.
N.
 
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NRaizman said:
Your surgeon is correct - this is coded as 27134 for an articulating spacer. If it is a static spacer, then 27091 would be correct.
This is has been noted in CPT-Assistant and also AAOSNow as the position of both AAOS and KZA.
N.
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When the static spacer is replaced with the new prothesis, how would that be coded? Would that be a conversion or revision? I feel it would be 27132 since the total had already be removed when the static spacer was placed.
 
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bostonmom said:
When the static spacer is replaced with the new prothesis, how would that be coded? Would that be a conversion or revision? I feel it would be 27132 since the total had already be removed when the static spacer was placed.
Click to expand...
An articulating spacer is not considered different from a metal/poly prosthesis and is coded like a revision.
 
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