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Wiki Total Hip Arthroplasty Revision

drewvinson23

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Vancouver, WA
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Can someone help me with the coding of the following procedures:

1. Left total hip arthroplasty revision, conversion to constrained liner (I believe this is CPT 27134?)
2. Left hip debridement and irrigation, down to and including removal of bone (CPT 11044? Is this bundled with the main procedure?)
3. Open advancement of hip abductor tendons (CPT 27299 matched to 27098? Again, is this considered incidental to the primary procedure?)
 
Total Hip Revision

There are a couple of different codes that would work here depending on what components in the hip are replaced. The American Academy of Orthopedic Surgeons (AAOS) recommends 27134 if both the acetabular component and the femoral components are replaced. If only the acetabular component, or only the liner is replaced would code 27137, and, if only the liner add a modifier 52. If only the femoral component is replaced code 27138.
Per the AAOS Global Service Data (GSD) the I&D and the repair of the capsule (advancement of hip abductor tendons) are both considered inclusive components of 27134, 27137, and 27138.

Elizabeth Redman, CPC, COSC
 
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