KristinM522
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Every time my Docs do this I get stumped, coming to you all to see if anyone has any concrete information on how to code it.
Patient had a bipolar hemiarthroplasty 1 week ago, fell resulting in a periprosthetic fracture. Returns to the OR for a revision of the bipolar hemiarthroplasty. Do you code 27236 again or use a revision hip CPT code? Op note below... Thanks in advance!
Patient had a bipolar hemiarthroplasty 1 week ago, fell resulting in a periprosthetic fracture. Returns to the OR for a revision of the bipolar hemiarthroplasty. Do you code 27236 again or use a revision hip CPT code? Op note below... Thanks in advance!
"Posterior capsule was taken down and the bipolar head was exposed. It was removed as was the stem without much difficulty.
The fracture was exposed as well. There is a longitudinal fracture as seen on CT scan. This was reduced with bone reduction forceps. Is able to place 2 cables around the proximal femur. They were appropriately tensioned and clamped. This produced excellent reduction of the fracture. A third cable was placed just distal to the fracture extent to prevent further propagation.
The wound was copiously irrigated with 3 L of pulsatile lavage. The proximal femur was then exposed. Canal finder was placed and I reamed in a sequential fashion using the reamers from the Arcos set. Once I had reached 15.5 sufficient chatter was encountered. I then sequentially broached to 16 with produced good fill.
I trialed a standard neck, 0 head and 44 mm ball. Limb lengths were nearly equal and stability was excellent. At 9 degrees of hip flexion and 30 degrees of adduction she had 90 degrees of internal rotation.
The trials were then removed. Canal and wound were copiously irrigated. Final stem of size 16 was impacted into position. This achieved excellent fixation during impaction. I again trialed and was satisfied with the previous hardware. A size 0 head with 44 mm cup was then impacted into position. Hip was reduced. Final performance was equal to trial performance."The fracture was exposed as well. There is a longitudinal fracture as seen on CT scan. This was reduced with bone reduction forceps. Is able to place 2 cables around the proximal femur. They were appropriately tensioned and clamped. This produced excellent reduction of the fracture. A third cable was placed just distal to the fracture extent to prevent further propagation.
The wound was copiously irrigated with 3 L of pulsatile lavage. The proximal femur was then exposed. Canal finder was placed and I reamed in a sequential fashion using the reamers from the Arcos set. Once I had reached 15.5 sufficient chatter was encountered. I then sequentially broached to 16 with produced good fill.
I trialed a standard neck, 0 head and 44 mm ball. Limb lengths were nearly equal and stability was excellent. At 9 degrees of hip flexion and 30 degrees of adduction she had 90 degrees of internal rotation.