ICD-10-PCS Billable Code

0SUR09Z

Supplement Hip Joint, Femoral Surface, Right to No Qualifier with Liner, Open Approach

Procedural Specifications

Clinical Axis Detail Definition
Section0 Medical and Surgical
Body SystemS Lower Joints
OperationU Supplement
Body PartR Hip Joint, Femoral Surface, Right
Approach0 Open
Device9 Liner
QualifierZ No Qualifier

Operation Definition

Putting in or on biological or synthetic material that physically reinforces and/or augments the function of a portion of a body part

Procedure Overview

Supplement procedures add biological or synthetic material to reinforce or augment a lower joint that is still structurally present but needs additional support. Ligament reconstruction, such as an ACL or PCL graft in the knee, is the classic example, along with labral augmentation in the hip or cartilage grafting. Unlike replacement, the native joint stays in place; the surgery strengthens a weakened or torn portion of it.

Grafts can come from the patient's own tissue, a donor, or synthetic material, and the choice often depends on age, activity level, and the structure being reinforced. These procedures are common after athletic injuries, aiming to restore stability so the joint can withstand normal or athletic loads again.

Anatomy & Axis Detail

Hip Joint, Femoral Surface, Right

The femoral surface of the right hip joint, the ball-shaped head of the femur that articulates within the acetabulum, is supplemented when its cartilage has worn thin from early osteoarthritis or focal osteonecrosis but the joint has not yet progressed to a state requiring total replacement. Surgeons apply a cartilage-resurfacing material or biologic graft directly to the femoral head to restore a smoother gliding surface against the acetabulum, aiming to delay the need for arthroplasty in younger or more active patients. Because the hip is a deep ball-and-socket joint bearing enormous compressive load, the procedure requires careful surgical access, and documentation must distinguish which surface, femoral versus acetabular, received the graft, since each is coded to its own body part value.

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: Liner

A Liner in Medical and Surgical procedures is an insert placed within a prosthetic component, commonly the polyethylene or ceramic sleeve fitted inside an acetabular cup during hip arthroplasty, providing a wear surface between the shell and femoral head. It is typically part of a modular replacement rather than the entire joint substitute. It differs from a Resurfacing Device, which caps existing bone surfaces rather than lining an implanted shell.

Coding & Documentation

Coders assign Supplement when documentation shows material was added to reinforce an existing body part rather than substitute for it, which requires confirming the native structure was not removed. Graft type, whether autograft, allograft, or synthetic, factors into the device value. A recurring mistake is coding a ligament reconstruction as Repair when a formal graft was placed, or conversely coding Supplement when the graft actually replaced a joint surface rather than reinforcing intact tissue.

Commonly Confused With

RepairSupplement is most often confused with Repair, since both can appear in operative notes for ligament work; the distinction is whether material was grafted in to reinforce the structure versus simply resutured or tightened without added tissue.
ReplacementIt also borders Replacement when a graft is extensive enough to functionally substitute for the original structure rather than reinforce it.