Wiki Revision of total hip replacement w/o all components

[Coral Denham]

Good morning,

I have a question I am wondering if you can help me with? My physician is going to revise a patient's total hip replacement due to dislocation. He intends to exchange the modular head and acetabular line, without removing or replacing either the femoral stem or acetabular shell. I am thinking that maybe it would qualify as 27138 (Revision of total hip arthroplasty; femoral component only, with or without allograft) Any guidance would be appreciated.

Thank you,

Coral

 

[nickelclaw]

27137 for the acetabular component only
27138 is femoral component
it does state acetabular line that is why I chose 27137. Both codes include the removal and insertion of new implant. These implants are often
modular, such as the head and liner for the hip. Coding depends of location of the component

 

[nolanspade]

It's important to understand the hardware. Don't confuse liner with cup - the total hip system usually has four parts - femoral stem inside the leg bone, femoral head (the ball), polyethylene liner (the acetabular liner to cushion metal/metal), and the acetabular cup (metal cup implanted in hip socket).

As far as the head/liner exchange, I've seen different guidance.

If there us a mechanical/wear problem with the actual hardware, you bill the revision. For femoral head/acetabular liner exchange, use -52 modifier, and one of the two codes according to which is more symptomatic, 27137 or 27138.

If there is a hematoma/debridement and the hardware is only exchanged as part of the debridement process, I've seen guidance (I have not adopted this myself yet) that a debridement or arthrotomy code should be used instead. I'm looking for a resource to pinpoint the validity.