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CPT and ICD coding tips for Total hip arthroplasty

Procedure performed for Total Hip Arthroplasty

Before we start learning about the ICD and CPT codes related to Total hip arthroplasty, procedure we will just checkout how the whole procedure is performed. The Patient is placed in lateral decubitus position and the physician makes an incision along the posterior aspect of the hip. The joint capsule is exposed by releasing the short external rotator muscles on the femur. The physician incises the capsule. The hip is dislocated posteriorly. The physician uses a saw to removal the femoral head. Any osteophytes around the rim of the acetabulum are removed using osteostome. Both subcondral and cancellous bone of acetabulum is exposed using a power reamer. After this, an acetabulum component is placed. Now attention is turned towards femoral canal. The femoral canal is enlarged with a rasp. The stem is secured into the femoral shaft. The stem is inserted and placed into place with an impactor. The physician may augment the area with autograft or allograft. The graft can be harvested from the removed femoral head or from a donor. The bone graft is placed into the canal and acetabulum. The external rotator muscles are reattached.

Cpt Code 27130

Arthroplasty, acetabular and proximal femoral prosthetic replacement (total hip arthroplasty), with or without autograft or allograft

CPT and ICD coding tips for Total hip arthroplasty

ICD 9 and ICD 10 code for Total hip arthroplasty

For ICD 9 we use to use to diagnosis codes for Total hip replacement or arthroplasty. First code tells the status code for joint replacement and the second code tell the which joint has been replaced. Same goes with ICD 10 as well but will have more specific ICD 10 codes for Total hip arthroplasty or replacement. In ICD 10 we will have separate diagnosis codes for right, left, bilateral or unspecified joint being replaced. Below are the ICD 9 and ICD 10 codes for Total hip arthroplasty for unspecified hip.

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ICD 9 code for Total hip replacement

V54.81 Aftercare following joint replacement surgery
V43.64 Presence of unspecified artificial hip joint

ICD 10 code for Total hip replacement

Z47.1 Aftercare following joint replacement surgery
Z96.649 Presence of unspecified artificial hip joint

Do and Don’t with CPT code for Total hip arthroplasty

The CPT code for Total hip arthroplasty or replacement includes both the femoral and acetabular components.

Do not code for Bone graft separately. The bone graft harvested used in this procedure is included in this CPT code.

Use CPT code 27125 for partial hip replacement or prosthesis like femoral stem prosthesis or bipolar arthroplasty

Use CPT code 27134 for revision of Total hip arthroplasty with both components, with or without use of autograft or allograft.

For removal of hip prosthesis without concurrent revision/replacement, check out 27090-27091 code series.

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