Joint Replacement Coding - AHIMA

1 Copyright 2007 American Health Information Management Association. All rights reserved. Joint Replacement Coding Audio Seminar/Webinar June 14, 2007 Practical Tools for Seminar Learning Disclaimer AHIMA 2007 Audio Seminar Series i The American Health Information Management Association makes no representation or guarantee with respect to the contents herein and specifically disclaims any implied guarantee of suitability for any specific purpose. AHIMA has no liability or responsibility to any person or entity with respect to any loss or damage caused by the use of this audio seminar, including but not limited to any loss of revenue, interruption of service, loss of business, or indirect damages resulting from the use of this program.

2 AHIMA makes no guarantee that the use of this program will prevent differences of opinion or disputes with Medicare or other third party payers as to the amount that will be paid to providers of service. CPT five digit codes, nomenclature, and other data are copyright 2006 American Medical Association. All Rights Reserved. No fee schedules, basic units, relative values or related listings are included in CPT. The AMA assumes no liability for the data contained herein. As a provider of continuing education, the American Health Information Management Association ( AHIMA ) must assure balance, independence, objectivity and scientific rigor in all of its endeavors. AHIMA is solely responsible for control of program objectives and content and the selection of presenters.

3 All speakers and planning committee members are expected to disclose to the audience: (1) any significant financial interest or other relationships with the manufacturer(s) or provider(s) of any commercial product(s) or services(s) discussed in an educational presentation; (2) any significant financial interest or other relationship with any companies providing commercial support for the activity; and (3) if the presentation will include discussion of investigational or unlabeled uses of a product. The intent of this requirement is not to prevent a speaker with commercial affiliations from presenting, but rather to provide the participants with information from which they may make their own judgments. Faculty AHIMA 2007 Audio Seminar Series iiElisabeth Parker Janeway, CPC, CCS-P, CCP Ms.

4 Janeway is a private healthcare consultant based in Winston Salem, North Carolina. She has been in the healthcare field for over ten years, offering physician and staff training , auditing services and a wide variety of other Coding and consulting services. She serves as a consultant for Sinaiko Healthcare Consulting, is a member of the Editorial Advisory Boards for the 'Orthopedic Coding Alert' and 'Part B Insider', sits on Cigna Medicare's Provider Communications Advisory Committee, speaks frequently for The Coding Institute, and is an active member of AHIMA and the AAPC, where she has been certified orthopaedic proficient. David V. Janeway, MD Dr. Janeway is President of Orthopaedic Specialists of the Carolinas and director of outpatient orthopaedic surgery and chairman of the arthroscopy section at Forsyth Medical Center in Winston- Salem, NC.

5 Dr. Janeway has over 20 years of medical experience, and is board-certified in orthopaedic surgery. He received his training at Wake Forest University Baptist Medical Center, Winston-Salem, NC and served as a Major in the Army Reserve from 1988 to 1996. Active duty at the 312th EVAC Hospital in Saudi, Arabia during Operation Desert Storm/Shield in 1990-1991. He is an active member of many national and regional medical societies and the orthopaedic team physician at Reagan High School in Winston-Salem. Table of Contents AHIMA 2007 Audio Seminar Series Disclaimer ..i Faculty ..ii Objectives .. 1 Arthroplasty Hip .. 2 Hip Revisions .. 4 Knee .. 5 Knee 9 Shoulder Revisions ..14 Ankle ..14 Hand ..16 Elbow ..20 Wrist ..22 Foot.

6 23 Disc ..25 Audience Questions Appendix ..31 CE Certificate Instructions Joint Replacement Coding AHIMA 2007 Audio Seminar Series 1 CPT Codes Copyright 2006 by AMA. All Rights Reserved Notes/Comments/QuestionsObjectiveswProvi de a clinical update on advances in Joint surgery CPT Coding guidelines for Joint Replacement surgery and ArthroplastywArthroplasty Head to toe2 Joint Replacement Coding AHIMA 2007 Audio Seminar Series 2 CPT Codes Copyright 2006 by AMA. All Rights Reserved Notes/Comments/QuestionsArthroplastywThe Top Three Total Hip Total Knee Total Shoulder3 ArthroplastywHip Anatomy Acetabulum Femoral head4 Joint Replacement Coding AHIMA 2007 Audio Seminar Series 3 CPT Codes Copyright 2006 by AMA. All Rights Reserved Notes/Comments/QuestionsArthroplastywPro sthesis Cemented Press fit Metal on plastic Metal on metal ceramic5 ArthroplastywPost op x-rayCPT 27130: Arthroplasty, acetabular and proximal femoral Prosthetic Replacement , with or without autograft or allograft6 Joint Replacement Coding AHIMA 2007 Audio Seminar Series 4 CPT Codes Copyright 2006 by AMA.

7 All Rights Reserved Notes/Comments/QuestionsArthroplastywGir dlestone Salvage procedureCPT code 27122: acetabuloplasty; resection, femoral head7 ArthroplastywHip revisions Acetabulum (cup) Liner Femur (stem) Infections8 Joint Replacement Coding AHIMA 2007 Audio Seminar Series 5 CPT Codes Copyright 2006 by AMA. All Rights Reserved Notes/Comments/QuestionsArthroplasty CPT Codesw27132 Conversion of previous hip surgery to total hip arthroplastyw27134 Revision of THA, both componentsw27137 Revision of THA, acetabularcomponent onlyw27138 Revision of THA, femoral component only (all with or without autograft or allograft)9 ArthroplastywTotal kneewanatomy Femur Tibia patella10 Joint Replacement Coding AHIMA 2007 Audio Seminar Series 6 CPT Codes Copyright 2006 by AMA.

8 All Rights Reserved Notes/Comments/QuestionsArthroplastywTot al knee prostheses Rotating platform11 ArthroplastywTotal knee prostheses Fixed platform12 Joint Replacement Coding AHIMA 2007 Audio Seminar Series 7 CPT Codes Copyright 2006 by AMA. All Rights Reserved Notes/Comments/QuestionsArthroplastywTot al knee x-raywCPT code 27447: Arthroplasty, knee, condyle and plateau; medial AND lateral compartments, with or without patella resurfacing13 ArthroplastywUnicompartmentalarthroplast y14 Joint Replacement Coding AHIMA 2007 Audio Seminar Series 8 CPT Codes Copyright 2006 by AMA. All Rights Reserved Notes/Comments/QuestionsArthroplastywUni knee15 ArthroplastywUni knee x-raywCPT code 27446: Arthroplasty, knee, condyle and plateau; medial OR lateral compartment16 Joint Replacement Coding AHIMA 2007 Audio Seminar Series 9 CPT Codes Copyright 2006 by AMA.

9 All Rights Reserved Notes/Comments/QuestionsArthroplastywuni -spacer17 ArthroplastywRevisions Poly exchange Femoral component Tibial component patella18 Joint Replacement Coding AHIMA 2007 Audio Seminar Series 10 CPT Codes Copyright 2006 by AMA. All Rights Reserved Notes/Comments/QuestionsArthroplasty CPT Codesw27486: Revision of total knee arthroplasty, with or without allograft; one componentw27487: Revision of TKA, with or without allograft; femoral and entire tibial componentw27488: Removal of prosthesis, including total knee prosthesis, methylmethacrylaewith or without insertion of spacer, knee19 ArthroplastywShoulder anatomy Humeral head glenoid20 Joint Replacement Coding AHIMA 2007 Audio Seminar Series 11 CPT Codes Copyright 2006 by AMA.

10 All Rights Reserved Notes/Comments/QuestionsArthroplastywTot al shoulder21 ArthroplastywResurfacing coffield22 Joint Replacement Coding AHIMA 2007 Audio Seminar Series 12 CPT Codes Copyright 2006 by AMA. All Rights Reserved Notes/Comments/QuestionsArthroplastywHem i-cap arthroplasty23 ArthroplastywReverse shoulder arthroplasty24 Joint Replacement Coding AHIMA 2007 Audio Seminar Series 13 CPT Codes Copyright 2006 by AMA. All Rights Reserved Notes/Comments/QuestionsArthroplastyReve rse shoulder25 Arthroplasty CPT Codesw23470: Arthroplasty, glenohumeral Joint ; hemiarthroplastyw23472: Arthroplasty, glenohumeral Joint ; (glenoid and proximal humeral Replacement (eg. Total shoulder)26 Joint Replacement Coding AHIMA 2007 Audio Seminar Series 14 CPT Codes Copyright 2006 by AMA.)