TKR - revision

JRPATJRPAT
in Home Care Coding General
Patient had right knee revision due to patient's right knee prosthesis becoming dislocated.

Would I code primary dx as:

T84.022D (instability of internal right knee prosthesis)

Or

Z47.33 (aftercare following explanation of knee joint prosthesis)

Comments

  • JRPATJRPAT
    Thank you, I had a feeling it should be that way.
  • kcarterkcarter
    We listened to a decision health tips and tricks webinar Monday regarding orthopedic aftercare.
    They advised to continue to use the complication code (in your example T84.022D - instability of internal right knee prosthesis) even after the revision, NOT to use the Z47 code for surgical aftercare. Their rationale was the same as that provided for continuing to use the fracture code after the fracture is surgically removed in a joint replacement.
  • kcarterkcarter
    That was the guidance provided by in the decision health webinar.
    T84.022D Primary and the prosthetic joint coded on the claim as well. Do not use Z47.33 for a revision d/t a complication.
  • kcarterkcarter
    Decision health said they or someone else also asked for that clarification and the three of us watching the webinar didn't really think there was a concrete answer to when you would use Z47.3
    I guess, like Vinnie said, if the physician does not state the reason for revision is a complication. Ie, revised d/t past the life expectancy of the prosthesis?
  • AmishanxAmishanx
    What do u mean by Completely replaced, most of the time info we get is revision only without more clarification.. So even if it was complication but complete new joint prosthetic is placed we code Z47.3 not complication as per above example. I think we need more clarification from Trish or one of the editor
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