ICD-10-PCS Billable Code

0SWR4JZ

Revision Hip Joint, Femoral Surface, Right to No Qualifier with Synthetic Substitute, Percutaneous Endoscopic Approach

Procedural Specifications

Clinical Axis Detail Definition
Section0 Medical and Surgical
Body SystemS Lower Joints
OperationW Revision
Body PartR Hip Joint, Femoral Surface, Right
Approach4 Percutaneous Endoscopic
DeviceJ Synthetic Substitute
QualifierZ No Qualifier

Operation Definition

Correcting, to the extent possible, a portion of a malfunctioning device or the position of a displaced device

Procedure Overview

Revision procedures correct a malfunctioning device already implanted in a lower joint, or reposition a device that has shifted out of place, without necessarily removing and replacing the whole implant. Examples include tightening a loosened hip component, adjusting a worn knee liner, or repositioning a dislocated joint implant back into alignment. The reason for surgery is a problem with hardware from an earlier operation rather than new injury to native tissue.

These procedures are often needed years after an initial joint replacement, as components can loosen, wear, or shift with normal use. Surgeons aim to fix the specific mechanical problem while preserving as much of the existing implant and surrounding bone as possible, since more extensive revisions carry greater surgical risk and longer recovery.

Anatomy & Axis Detail

Hip Joint, Femoral Surface, Right

Revision of the right hip joint at the femoral surface addresses complications on the femoral side of a total or partial hip arthroplasty, such as a stem that has loosened, subsided, or fractured, or a femoral head component that has worn excessively against its counterpart. Because the femoral component bears the majority of axial load transmitted through the hip during standing and walking, failure here often presents as thigh pain, limb shortening, or instability, and correction may involve exchanging the femoral stem or head, repositioning a well-fixed but malaligned component, or removing hardware in the setting of infection. Coding should reflect specifically that the corrective work targeted the femoral articular surface rather than the acetabular side, since revision procedures often address only one component of the joint.

Approach: Percutaneous Endoscopic

Percutaneous Endoscopic combines a puncture through skin or mucous membrane with insertion of an endoscope to visualize the procedure internally, as in laparoscopic cholecystectomy. It is distinguished from plain Percutaneous by the presence of scope-guided visualization, and from Via Natural or Artificial Opening Endoscopic by its route being a new puncture rather than an existing orifice or stoma.

Device: Synthetic Substitute

Synthetic Substitute designates a device made from manufactured, non-biologic material, such as mesh or prosthetic components, used to replace or augment a body part. It is distinguished from the two tissue substitute categories by its artificial composition, which carries different considerations for integration and long-term durability than biologic grafts.

Coding & Documentation

Documentation needs to identify that an existing device was the target of correction, whether through repositioning, adjustment, or partial component exchange, and that the fix did not amount to a full swap of the entire prosthesis. Notes describing loosening, malposition, or component wear typically support Revision. A common error arises when a full component exchange occurs during a documented revision surgery; if the entire device is replaced, the correct root operation is Replacement, even though the surgeon may call it revision arthroplasty.

Commonly Confused With

ReplacementRevision is most commonly confused with Replacement because both terms appear in the context of a failed prior implant; the difference is whether the existing device is corrected or repositioned versus entirely exchanged.
RemovalIt can also be confused with Removal, since Removal alone takes hardware out without correcting malfunction or reinserting anything in its place.