June 14, 2018

Question:
We have a patient who underwent an open fixation of a femoral neck fracture five years ago and now presents for a total hip arthroplasty.   Someone mentioned that we should report a conversion to hip arthroplasty but we are not sure if this is a revision of one component plus a hemiarthroplasty?

Answer:
The advice you received related to reporting this as a conversion to total hip arthroplasty is correct.  The patient is not in a global period, so you will report 27132 (Conversion of previous hip surgery to total hip arthroplasty, with or without autograft or allograft).  The concept of reporting the conversion code versus a primary hip arthroplasty is that the patient has had prior open hip surgery, and the value of the conversion code reflects that the procedure is typically more difficult than a primary arthroplasty procedure.

Do not unbundle and report the removal of one component and a hemi-arthroplasty or other revision codes for the described circumstance.

*This response is based on the best information available as of 06/14/18.