Hip Systems Coding Reference Guide - Zimmer …

1 PhysicianCPT CodeCPT Description2712 5 Hemiarthroplasty, hip, partial (eg, femoral stem prosthesis, bipolar arthroplasty)2713 0 Arthroplasty, acetabular and proximal femoral prosthetic replacement (total hip arthroplasty), with or without autograft or allograft27132 Conversion of previous hip surgery to total hip arthroplasty, with or without autograft or allograftPhysician RevisionCPT CodeCPT Description2713 4 Revision of total hip arthroplasty; both components, with or without autograft or allograft27137 Revision of total hip arthroplasty; acetabular component only, with or without autograft or allograft2713 8 Revision of total hip arthroplasty; femoral component only, with or without allograftHospital Outpatient and Free-Standing Ambulatory Surgery Center (ASC)CPT CodeCPT DescriptionOPPS Status IndicatorAPCASC Payment Indicator2712 5 Hemiarthroplasty, hip, partial (eg, femoral stem prosthesis, bipolar arthroplasty)C--NA2713 0 Arthroplasty, acetabular and proximal femoral prosthetic replacement (total hip arthroplasty), with or without autograft or allograftC--NA27132 Conversion of previous hip surgery to total hip arthroplasty, with or without autograft or allograftC--NA2713 4 Revision of total hip arthroplasty; both components, with or without autograft or allograftC--NA27137 Revision of total hip arthroplasty; acetabular component only, with or without autograft or allograftC--NA2713 8 Revision of total hip arthroplasty; femoral component only, with or without allograftC--NAOPPS Outpatient Prospective Payment system .

2 APC Ambulatory Payment ClassificationStatus Indicator C Not paid under OPPSNA This procedure is not on Medicare s List of ASC Covered Surgical InpatientMS-DRG and Description*466 Revision Of Hip Or Knee Replacement with MCC467 Revision Of Hip Or Knee Replacement with CC468 Revision Of Hip Or Knee Replacement without CC/MCC469 Major Joint Replacement Or Reattachment Of Lower Extremity with MCC470 Major Joint Replacement Or Reattachment Of Lower Extremity without MCCCC Complication and/or Comorbidity, MCC Major Complication and/or Comorbidity*MS-DRG Medicare Severity Diagnosis Related Group. Other MS-DRGs may applyHip Systems Coding Reference GuideICD-10-PCS CodeICD-10-PCS Description S R9 19 Replacement of right hip joint with metal synthetic substitute, cemented, open approach S R9 1 AReplacement of right hip joint with metal synthetic substitute, uncemented, open approach S R9 1 ZReplacement of right hip joint with metal synthetic substitute, open approach SR9 29 Replacement of right hip joint with metal on polyethylene synthetic substitute, cemented, open approach SR9 2 AReplacement of right hip joint with metal on polyethylene synthetic substitute, uncemented, open approach SR9 2 ZReplacement of right hip joint with metal on polyethylene synthetic substitute, open approach SR9 39 Replacement of right hip joint with ceramic synthetic substitute, cemented, open approach SR9 3 AReplacement of right hip joint with ceramic synthetic substitute, uncemented, open approach SR9 3 ZReplacement of right hip joint with ceramic synthetic substitute.

3 Open approach SR9 49 Replacement of right hip joint with ceramic on polyethylene synthetic substitute, cemented, open approach SR9 4 AReplacement of right hip joint with ceramic on polyethylene synthetic substitute, uncemented, open approach SR9 4 ZReplacement of right hip joint with ceramic on polyethylene synthetic substitute, open approach SR9 J9 Replacement of right hip joint with synthetic substitute, cemented, open approach SR9 JAReplacement of right hip joint with synthetic substitute, uncemented, open approach SR9 JZReplacement of right hip joint with synthetic substitute, open approach S R A 19 Replacement of right hip joint, acetabular surface with metal synthetic substitute, cemented, open approach S R A 1 AReplacement of right hip joint, acetabular surface with metal synthetic substitute, uncemented, open approach S R A 1 ZReplacement of right hip joint, acetabular surface with metal synthetic substitute, open approach SR A 39 Replacement of right hip joint, acetabular surface with ceramic synthetic substitute, cemented, open approach SR A 3 AReplacement of right hip joint, acetabular surface with ceramic synthetic substitute, uncemented, open approach SR A 3 ZReplacement of right hip joint, acetabular surface with ceramic synthetic substitute, open approach SRA 9 Replacement of right hip joint, acetabular surface with polyethylene synthetic substitute, cemented, open approach SRA AReplacement of right hip joint, acetabular surface with polyethylene synthetic substitute, uncemented, open approach SRA ZReplacement of right hip joint, acetabular surface with polyethylene synthetic substitute, open approach SRB 19 Replacement of left hip joint with metal synthetic substitute, cemented, open approach SRB 1 AReplacement of left hip joint with metal synthetic substitute, uncemented, open approach SRB 1 ZReplacement of left hip joint with metal synthetic substitute.

4 Open approach SRB 29 Replacement of left hip joint with metal on polyethylene synthetic substitute, cemented, open approach SRB 2 AReplacement of left hip joint with metal on polyethylene synthetic substitute, uncemented, open approach SRB 2 ZReplacement of left hip joint with metal on polyethylene synthetic substitute, open approach SRB 39 Replacement of left hip joint with ceramic synthetic substitute, cemented, open approach SRB 3 AReplacement of left hip joint with ceramic synthetic substitute, uncemented, open approach SRB 3 ZReplacement of left hip joint with ceramic synthetic substitute, open approach SRB 49 Replacement of left hip joint with ceramic on polyethylene synthetic substitute, cemented, open approach SRB 4 AReplacement of left hip joint with ceramic on polyethylene synthetic substitute, uncemented, open approach SRB 4 ZReplacement of left hip joint with ceramic on polyethylene synthetic substitute, open approach SRB J9 Replacement of left hip joint with synthetic substitute, cemented, open approach SRB JAReplacement of left hip joint with synthetic substitute, uncemented, open approach SRB JZReplacement of left hip joint with synthetic substitute, open approach SU9 9 ZSupplement right hip joint with liner, open approach SUA 9 ZSupplement right hip joint, acetabular surface with liner, open approach SUB 9 ZSupplement left hip joint with liner, open approach SUE 9 ZSupplement left hip joint, acetabular surface with liner, open approachRevision SW9 8 ZRevision of spacer in right hip joint, open approach SW9 9 ZRevision of liner in right hip joint, open approach SW9 BZRevision of resurfacing device in right hip joint, open approach SW9 JZRevision of synthetic substitute in right hip joint, open approach SWB 8 ZRevision of spacer in left hip joint, open approach SWB 9 ZRevision of liner in left hip joint, open approach SWB BZRevision of resurfacing device in left hip joint.

5 Open approach SWB JZRevision of synthetic substitute in left hip joint, open approachHCPCSHCPCS CodeHCPCS DescriptionC 17 76 Joint device (implantable)HCPCS Healthcare Common Procedure Coding SystemNote: C-codes report devices used in conjunction with outpatient procedures billed and paid for under Medicare OPPSFor further assistance with Coding and reimbursement questions, contact the Zimmer Biomet Reimbursement Hotline at 866-946-0444 or Procedural Terminology (CPT ) copyright 2016 American Medical Association. All rights reserved. CPT is a registered trademark of the American Medical Biomet Coding Reference Guide Disclaimer The information in this document was obtained from third party sources and is subject to change without notice, including as a result in changes in reimbursement laws, regulations, rules and policies. All content in this document is informational only, general in nature and does not cover all situations or all payers rules or policies. The service and the product must be reasonable and necessary for the care of the patient to support reimbursement.

6 Providers should report the procedure and related codes that most accurately describe the patients medical condition, procedures performed and the products used. This document represents no promise or guarantee by Zimmer Biomet regarding coverage or payment for products or procedures by Medicare or other payers. Providers should check Medicare bulletins, manuals, program memoranda, and Medicare guidelines to ensure compliance with Medicare requirements. Inquiries can be directed to the provider s respective Medicare Administrative Contractor, or to appropriate payers. Zimmer Biomet specifically disclaims liability or responsibility for the results or consequences of any actions taken in reliance on information in this