Health Information Management

Q&A: Coding for arthroscopic patellofemoral resurfacing

HIM-HIPAA Insider, December 6, 2011

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Q: How should we code arthroscopic patellofemoral resurfacing? Some physicians want to code this as a knee replacement, but they are merely resurfacing and replacing the articular joint.

A: Currently, there are no codes for resurfacing of the knee. However, there are codes for hip resurfacing, sometimes referenced as arthroplasties. Learn more by accessing Coding Clinic, Fourth Quarter 2006, pp. 121-122.

When a joint replacement exceeds that which is medically necessary but everything else a physician tries is insufficient, the physician may resort to using an arthrosurface HemiCAP® implant. This is a metal cap individually fitted to the damaged portion of joint cartilage. This is similar to the way dentists fill cavities.

The HemiCAP resurfacing system is a comprehensive surgical solution for the treatment of lesions and defects in the body’s weight-bearing, non-weight-bearing, and extremity joints. Report arthroscopic knee replacements with ICD-9-CM procedure code 81.47 (other repair of knee). Report ICD-9-CM procedure code 81-54 (total knee replacement) when a physician performs both unicompartmental and patellofemoral repairs.

Editor’s note: Sandra L. Sillman, RHIT, PAHM, DRG coordinator at Henry Ford Hospital & Health Network in Detroit, answered this question, which originally appeared on Just Coding on September 13, 2011.



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