Wiki Tha and revision tha in same surgical session

[LindsayAllen]

Surgeon performs total hip arthroplasty on patient who had leg length discrepency on a previous total hip arthroplasty on left side done elsewhere and was very concerned that it would happen again, surgeon flips patient to supine position after performing tha on right side and notices leg length discrepnecy so he flips patient back over and performs a revision total hip arthroplasty removing prosthesis that he just inserted and increasing prosthesis sizes in the same session. How should this be coded?

 

[Orthocoderpgu]

two cents: 27130

I vote for 27130. I code a lot of THA and the physicians always check leg length before cementing the final components in place and closing. Now, if the documentation shows that the leg length was checked before closing, and the leg length was fine at that time, but then checked again after closing, and the leg length was not fine, then I would use modifier -22 for the THA. I have never seen leg length change after closing though. I would not code this as a revision since the components were not in place at the start of the session.