0SR902Z
Replacement Hip Joint, Right to No Qualifier with Synthetic Substitute, Metal on Polyethylene, Open Approach
Procedural Specifications
| Clinical Axis | Detail Definition |
|---|---|
| Section | 0 Medical and Surgical |
| Body System | S Lower Joints |
| Operation | R Replacement |
| Body Part | 9 Hip Joint, Right |
| Approach | 0 Open |
| Device | 2 Synthetic Substitute, Metal on Polyethylene |
| 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, Right
The right hip joint is the ball-and-socket articulation between the femoral head and the acetabulum of the pelvis, a weight-bearing joint essential to walking, standing, and transferring load from the trunk to the lower limb. Osteoarthritis, avascular necrosis, femoral neck fracture, and inflammatory arthropathy are common reasons this joint deteriorates to the point that replacement becomes the most effective treatment for pain and lost mobility. Replacement of the right hip joint removes the damaged femoral head and acetabular surface and substitutes them with prosthetic components, which may be metal, ceramic, or polyethylene depending on the bearing surface selected and the patient's activity level and bone quality. Because hip replacement can be total, involving both femoral and acetabular sides, or partial, involving only the femoral head, the extent of the procedure and the specific components used should be clearly documented.
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: Synthetic Substitute, Metal on Polyethylene
This value identifies a joint substitute with a metal component articulating against a polyethylene counterpart, the traditional and still widely used bearing combination in hip and knee arthroplasty, balancing durability with lower friction than metal-on-metal designs. It differs from all-metal substitutes and from newer combinations like Ceramic on Polyethylene or Oxidized Zirconium on Polyethylene, which use alternative materials on the hard-surface side to reduce wear.
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.