0SRA0KZ
Replacement Hip Joint, Acetabular Surface, Right to No Qualifier with Nonautologous Tissue Substitute, Open Approach
Procedural Specifications
| Clinical Axis | Detail Definition |
|---|---|
| Section | 0 Medical and Surgical |
| Body System | S Lower Joints |
| Operation | R Replacement |
| Body Part | A Hip Joint, Acetabular Surface, Right |
| Approach | 0 Open |
| Device | K Nonautologous Tissue Substitute |
| Qualifier | Z No Qualifier |
Operation Definition
Putting in or on biological or synthetic material that physically takes the place and/or function of all or a portion of a body part
Procedure Overview
Joint replacement in the lower extremities involves removing damaged or arthritic surfaces of a hip, knee, or ankle and implanting an artificial device that takes over the joint's function. Surgeons turn to this once medications, injections, and physical therapy no longer control the pain or stiffness of advanced osteoarthritis, rheumatoid arthritis, avascular necrosis, or a joint destroyed by prior trauma. The goal is restoring the ability to walk, climb stairs, and move without bone grinding on bone.
Implants are made of metal alloys, ceramic, or high-grade polyethylene, and a case can replace an entire joint (total) or a single compartment (partial). Recovery centers on physical therapy to build strength around the new joint; most patients regain substantial function within a few months, though the device will eventually wear and may need revision decades later.
Anatomy & Axis Detail
Hip Joint, Acetabular Surface, Right
The acetabulum is the cup-shaped socket in the pelvis that receives the femoral head, and its articular surface is the structure replaced when a prosthetic shell and liner are impacted into place during total hip arthroplasty. Coders document this component separately from the femoral side because ICD-10-PCS treats the acetabular cup and the femoral head as two distinct body parts, even though both are placed in a single operative session for a total hip replacement. Reasons for replacing this surface include osteoarthritis, avascular necrosis, dysplasia, or wear of a prior implant, and the bone stock quality of the acetabular rim often dictates whether cement fixation or a press-fit porous-coated cup is used, which the operative note should specify.
Approach: Open
Open approach means the surgeon cuts through skin, mucous membrane, or other tissue layers to physically expose the target site to view before performing the procedure. It gives direct visualization and hands-on access, distinguishing it from Percutaneous approaches where instruments pass through a small puncture without exposing the site. Open is typical for procedures needing wide access, such as most laparotomies.
Device: Nonautologous Tissue Substitute
Nonautologous Tissue Substitute refers to biologic material sourced from a donor or another species, such as an allograft or xenograft, used to replace a body part. It differs from Autologous Tissue Substitute by tissue origin outside the patient's own body, and from Synthetic Substitute by being biologic rather than manufactured material.
Coding & Documentation
A coder assigns Replacement when the operative note documents removal of the native articular surface and insertion of a device meant to permanently substitute for it, not merely resurface it. Documentation should specify the joint, laterality, and whether the procedure was total or partial, since these drive qualifier selection. A common error is confusing partial resurfacing that leaves native bone intact with full Replacement, or missing that a revision arthroplasty swapping the entire prosthesis is still Replacement rather than Revision.