RE: ICD 10 clarification please

edited May 2017 in Orthopedics
Looking at this a little closer – on the final stage:

It states Z47.32, Z89.622, Z96.642



If you look at Z47.32 it has a exclude 1 (acquired absence of knee/hip joint following prior explantation of prosthesis it states and also why would we code Z96.642 when there was not a prosthesis in we are replacing it now. Looks to me that we should only be coding the Z47.32 – am I missing something here – would like a better explanation. Thanks



From: Scalley123@aol.com [mailto:Scalley123@aol.com]
Sent: Tuesday, October 06, 2015 2:02 PM
To: Multiple Recipients of Ortho-L
Subject: Re: [ortho-l] ICD 10 clarification please



Per ICD Coding CLinic

• Patient has infected left total hip that they are staging the replacement

• First encounter to remove infected prosthesis – T84.52xA; Z96.642

• Final stage when placing new prosthesis – Z47.32; Z89.622, Z96.642

“Code V54.82, Aftercare following explantation of joint prosthesis, has been created to allow the reporting of patient encounters for aftercare following the removal of joint prosthesis. The aftercare includes encounters for joint replacement insertion surgery where it was necessary to stage the procedure or for joint prosthesis insertion following a prior explantation of the prosthesis. There may be a medical need to remove an existing joint prosthesis (e.g., due to infection or other problem), but it may not be possible to replace the prosthesis at the same encounter, thereby requiring a return encounter to insert a new prosthesis. This code may be used with the appropriate code from subcategory V88.2, Acquired absence of joint, to specifically identify the joint.” ICD-9 Coding Clinic 4th Otr 2011"



V54.82 cross walks Z47.3-
Also V88.2- cross walks to Z89-





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In a message dated 10/6/2015 11:25:27 A.M. Pacific Daylight Time, inpsa@fondren.com writes:

Staged Hip Prosthesis replacement:-
1st encounter - Hip prosthesis placement

2nd encounter - Hip prosthesis removal

3rd encounter – Hip Spacer - Z89.621 (Acquired absence of hip joint following explantation of hip joint prosthesis, with or without presence of antibiotic impregnated cement spacer)

4th encounter – Spacer removal & new prosthesis placement - Z47.32 (Aftercare following explantation of joint prosthesis, staged procedure & Encounter for joint prosthesis insertion following prior explantation of joint prosthesis)


thanks,
Padma A
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