silly question??

Patient had a hemi-arthroplasty of right hip....would I code aftercare joint replacement? (where its not total joint)...but same precautions.... or code the femur fracture?

Comments

  • edited April 2017
    It's still Z47.1, Z96.641
  • edited April 2017
    Coding Clinic clarifies joint replacement aftercare guidance
    08/22/2016

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    Continue to assign the injury code, for example S72.001D (Fracture of unspecified part of neck of right femur, subsequent encounter for closed fracture with routine healing), for patient who underwent a joint replacement to treat a hip fracture.



    The aftercare code Z47.1 (Aftercare following joint replacement surgery) is not appropriate in these types of scenarios, confirmed Nelly Leon-Chisen, director of coding and classification for the American Hospital Association, which publishes the Coding Clinic’s quarterly updates. Leon-Chisen confirmed this guidance during her session at DecisionHealth’s 14th annual Home Health Coding Summit.



    This guidance amounts to a substantial change from how the care of joint replacements done to treat fractures is coded. Previous wisdom held that once the fractured bone is surgically excised and replaced with a prosthetic joint, the fracture no longer exists and the aftercare code is the only logical choice. Megan Gustafson (mgustafson@decisionhealth.com)



    Editor's note: Stay tuned to future issues of Diagnosis Coding Pro for Home Health for further coverage of the coding of joint replacements to treat fractures.
  • If the patient encountered a fracture and had a arthroplasty either total or hemi we were instructed to code it to the fracture with "D"
  • edited April 2017
    So, if a fracture occurs and the fracture is arthroplasty repaired, the
    fracture is coded, not Z47.1? If so, where is that clarification found?
  • It was in a release in August of 2016, I have added it below for you to view. Hope it helps!

    Continue to assign the injury code, for example S72.001D (Fracture of unspecified part of neck of right femur, subsequent encounter for closed fracture with routine healing), for patient who underwent a joint replacement to treat a hip fracture.

    The aftercare code Z47.1 (Aftercare following joint replacement surgery) is not appropriate in these types of scenarios, confirmed Nelly Leon-Chisen, director of coding and classification for the American Hospital Association, which publishes the Coding Clinic’s quarterly updates. Leon-Chisen confirmed this guidance during her session at DecisionHealth’s 14th annual Home Health Coding Summit.
  • Miram's answer below is correct. You still code the fracture (7th
    character D), but you can add the z96.641 at the bottom of your sequence.
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