Coding, Classification and Reimbursement

Coding Revision

  • 1.  Coding Revision

    Posted 01-24-2019 11:04
    Good Morning,
    Can someone help me out coding this scenario? A patient had an OA of R Hip and had a R THA done. She had a fall and occur a R Hip periprosthetic fracture. Surgeon had to do a revision of the R hip. What would be the Diagnosis code for this since the patient admitted to us for rehab? I assigned M9701XD for periprosthetic fracture, and Z96.641 for the presence of artificial hip joint. Please advise.

    Myra Salcedo


  • 2.  RE: Coding Revision

    Posted 02-01-2019 17:53
    Hi Myra,

    I always code the specific fracture code along with the periprosthetic fracture code.  So in total you would have 4 codes to describe this fracture:
    PDX:  hip fracture code, subsequent encounter
    add'l dx:  periprosthetic fx code, subsequent encounter
    add'l dx:  presence prosthetic hip
    add'l dx:  fall, subsequent encounter

    And if you do the IRF-PAI too then you would use initial encounter for the hip fracture code as your etiologic dx.  I think that gives a better description of the fracture than using the periprosthetic fx code as etiologic.

    Alicia Kellogg, RHIT
    Inpatient Coder