My provider performed a removal of the acetabular cup with placement of an antibiotic eluting spacer. The only code that I can come up with is 27091. Is this code only used when the total hip prosthesis is removed? If so, should I code it as 27091-52 since he only removed the acetabular component?
Using the patient's prior incision, incision was made proximally and laterally to the wound. The wound VAC was removed. There was a large amount of tissue debridement that was performed to the subcutaneous tissue area, as well as the IT band. The vastus lateralis and the gluteus medius were split using a modified Hardinge approach after which time the hip was dislocated and the ceramic head of the implant was removed, followed by insertion of a slap hammer to the femoral implant, which attempted removal was performed with a slap hammer. Stem was found to be fixed in place with no evidence of any loosening, after which time the cup was then assessed and the liner was removed. Posterior to the liner, there was a small amount of fluid which was taken for culture and sensitivity and sent for analysis to Pathology. The decision was made to remove the acetabular cup. One screw was removed followed by removal of the acetabular cup and placement of an antibiotic eluting spacer. Copious irrigation was performed with approximately 12 liters of normal saline, Betadine, as well as irrigant fluid.
Using the patient's prior incision, incision was made proximally and laterally to the wound. The wound VAC was removed. There was a large amount of tissue debridement that was performed to the subcutaneous tissue area, as well as the IT band. The vastus lateralis and the gluteus medius were split using a modified Hardinge approach after which time the hip was dislocated and the ceramic head of the implant was removed, followed by insertion of a slap hammer to the femoral implant, which attempted removal was performed with a slap hammer. Stem was found to be fixed in place with no evidence of any loosening, after which time the cup was then assessed and the liner was removed. Posterior to the liner, there was a small amount of fluid which was taken for culture and sensitivity and sent for analysis to Pathology. The decision was made to remove the acetabular cup. One screw was removed followed by removal of the acetabular cup and placement of an antibiotic eluting spacer. Copious irrigation was performed with approximately 12 liters of normal saline, Betadine, as well as irrigant fluid.