Procedure performed for Total Hip Arthroplasty (CPT code 27130)

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. A total hip replacement involves removal of diseased cartilage and bone from the acetabulum and femur with replacement using a prosthetic ball and socket. An incision is made over the lateral aspect of the hip. Soft tissue is dissected and released to allow exposure of the hip joint and dislocation of the femoral head from the acetabulum. The cartilage and bone are removed from the surface of the acetabulum using an osteotome.

A prosthetic cup is secured to the acetabulum. The femoral head is excised and the femoral shaft is reamed to allow insertion of the stem of the ball and stem component of the prosthesis. The stem is inserted into the prepared femoral shaft and secured using bone cement or a press-fit technique. If the ball is not attached to the stem it is attached and the ball component is placed into cup component. The prosthetic hip joint is taken through a full range of motion to ensure adequate stability and motion of the hip. A drain is placed and incisions are closed in layers around the drain. CPT code 27130 is used for reporting total hip arthroplasty procedure. Another term for arthroplasty could be “resurfacing.”

Cpt Code 27130

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

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ICD 9 and ICD 10 CM code for Total hip arthroplasty

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 is used by medical coders for coding total hip arthroplasty procedure.

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.

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

Z96.641 Presence of right artificial hip joint
Z96.642 Presence of left artificial hip joint
Z96.643 Presence of artificial hip joint, bilateral
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.

RVUs and Fees for CPT code 27130 for Total hip arthroplasty