ICD-10 Coding for Hip Replacement Surgery(0SRA0JZ, T84.53XA)
Complete ICD-10-CM coding and documentation guide for Hip Replacement Surgery. Includes clinical validation requirements, documentation requirements, and coding pitfalls.
Also known as:
Related ICD-10 Code Ranges
Complete code families applicable to Hip Replacement Surgery
0SR*Primary Range
ICD-10-PCS codes for hip replacement procedures
Covers all replacement procedures for hip joints, including total and partial replacements.
ICD-10-CM codes for complications of internal orthopedic prosthetic devices, implants, and grafts
Used for coding complications related to hip prostheses, such as infections or mechanical failures.
Code Comparison: When to Use Each Code
Compare key differences between these codes to ensure accurate selection
| Code | Description | When to Use | Key Documentation |
|---|---|---|---|
| 0SRA0JZ | Replacement of left hip joint with synthetic substitute, open approach | For primary total or partial hip replacement surgeries using a synthetic substitute. |
|
| T84.53XA | Infection and inflammatory reaction due to internal joint prosthesis, initial encounter | For initial encounters of infections related to hip prostheses. |
|
Clinical Decision Support
Always review the patient's clinical documentation thoroughly. When in doubt, choose the more specific code and ensure documentation supports it.
Key Information: ICD-10 code for hip replacement surgery
Essential facts and insights about Hip Replacement Surgery
Primary ICD-10-CM Codes for hip replacement surgery
Decision Criteria
clinical Criteria
- Patient has severe osteoarthritis confirmed by imaging.
documentation Criteria
- Operative report includes details of components and approach.
Applicable To
- Total hip replacement
- Partial hip replacement
Excludes
- Revision of hip replacement
- Removal of hip prosthesis
Clinical Validation Requirements
- Radiographic evidence of joint degeneration
- Documented pain interfering with activities of daily living
Code-Specific Risks
- Incorrect documentation of approach or components
- Omission of bearing surface details
Coding Notes
- Ensure documentation specifies the type of synthetic substitute and approach used.
T84.53XA - Infection and inflammatory reaction due to internal joint prosthesis, initial encounter
For initial encounters of infections related to hip prostheses.
Applicable To
- Infection of hip prosthesis
Excludes
- Mechanical complication of prosthesis
Clinical Validation Requirements
- Positive culture from joint aspirate
- Elevated inflammatory markers (ESR, CRP)
Coding Notes
Ensure infection is clearly linked to the prosthesis in documentation.
Ancillary Codes
Additional codes that should be used in conjunction with the main diagnosis codes when applicable.
Differential Codes
Alternative codes to consider when ruling out similar conditions to the primary diagnosis.
Documentation & Coding Risks
Avoid these common documentation and coding issues when documenting Hip Replacement Surgery to ensure proper reimbursement, maintain compliance, and reduce audit risk. These guidelines are particularly important when using ICD-10 code 0SRA0JZ.
Impact
Clinical: Inaccurate patient records., Regulatory: Non-compliance with documentation standards., Financial: Potential claim denials.
Mitigation Strategy
Use standardized templates, Review documentation guidelines
Impact
Reimbursement: Incorrect coding may lead to claim denials., Compliance: Non-compliance with coding guidelines., Data Quality: Inaccurate clinical data reporting.
Mitigation Strategy
Verify operative report for specific components replaced.
Impact
Lack of specific approach details can lead to audit flags.
Mitigation Strategy
Ensure all operative reports include detailed approach descriptions.
Documentation errors, coding pitfalls, and audit risks are interconnected aspects of medical coding and billing. Addressing all three areas helps ensure accurate coding, optimal reimbursement, and regulatory compliance.
Frequently Asked Questions
Common questions about ICD-10 coding for Hip Replacement Surgery, with expert answers to help guide accurate code selection and documentation.
Documentation Templates for Hip Replacement Surgery
Use these documentation templates to ensure complete and accurate documentation for Hip Replacement Surgery. These templates include all required elements for proper coding and billing.
Total Hip Replacement
Specialty: Orthopedic SurgeryRequired Elements
- Procedure type
- Approach
- Components replaced
- Bearing surface
Examples: Poor vs. Good Documentation
Poor Documentation Example
Good Documentation Example
Explanation
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