HIP Replacement
Bearing Surface Vol.3 Codes
Q. We are
having a problem in trying to use the new ICD-9 CM procedure codes for hip
replacement bearing surfaces: 00.74, 00.75, and 00.76. While we understand that the bearing surfaces
involve the materials used for the femoral heads and the liners or inserts
within the acetabular shells that articulate with these femoral head
components, our surgeons often fail to identify these materials in the
operative reports, forcing us to search for the product stickers in the chart
or to go on the manufacturer’s website to find the information we need. Is there any centralized resource that we can
go to that lists the names of the major metal, polyethylene, and ceramic
components available for hip replacement as well as the names of the
manufacturers who produce these components.
That would save us a lot of time.
A. To the best of our knowledge, there is no
centralized resource that does exactly what you request. As an attempt to remedy this situation, we
have a compiled a list below of the most commonly used manufacturers and their
bearing surface products matching them to the materials described in the new
ICD-9 CM procedure codes:
00.74 Hip
replacement bearing surface, metal on polyethylene
Biomet
(biomet.com)
Endo II cobalt chrome femoral head
Modular cobalt chrome femoral head
Offset cobalt chrome femoral head
ArCom polyethylene liners
ArComXL
highly cross-linked polyethylene liners
DePuy Orthopedics,
Inc. (depuy.com)
Articuleze cobalt chrome femoral heads
Enduron
polyethylene liners
Marathon cross-linked polyethylene liners
Hayes Medical
(hayesmed.com)
Cobalt chrome femoral heads
Millennium cross-linked polyethylene liners
Plus Orthopedics
(plusortho.com)
Cobalt chromium femoral heads
Smith & Nephew
(smith-nephew.com)
Cobalt chrome femoral heads
Reflection polyethylene liners
Reflection XLPE (cross-linked polyethylene
liners)
Stryker
Corporation (stryker.com)
C-Taper cobalt chrome femoral heads
LFIT (Low Friction Ion Treatment) cobalt
chromium femoral heads
V40 Vitallium femoral heads
Crossfire XLPE (highly cross-linked
polyethylene liners)
Trident constrained polyethylene inserts
Trident Eccentric polyethylene inserts
X3 polyethylene liners
Zimmer (zimmer.com)
Continuum superpolished 12/14 femoral heads
6 degree taper cobalt chrome femoral heads
Versys 12/14 cobalt chrome femoral heads
Durasul polyethylene liners
Epsilon Durasul constrained polyethylene
inserts
Longevity highly cross-linked polyethylene
liners
00.75 Hip
replacement bearing surface, metal-on-metal
Biomet
(biomet.com)
M2a – Magnum System
M2a- Taper System
DePuy Orthopedics,
Inc. (depuy.com)
Ultamet Metal-on-Metal Articulation
Encore Medical
(encoremed.com)
Encore Large Metal/Metal
Wright Medical
Technology (wmt.com)
Conserve Total Hip System with BFH Technology
Transcend Metal-on-Metal Articulation System
Zimmer (zimmer.com)
Metasul
Metal-on-Metal
00.76 Hip
replacement bearing surface, ceramic-on-ceramic
CeramTec (ceramtec.com)
Biolox delta ceramic femoral heads
Biolox
forte ceramic femoral heads
Biolox delta ceramic cup inserts
Biolox forte ceramic cup inserts
Depuy Orthopedics, Inc. (depuy.com)
Duraloc Option Ceramic Hip System (using
CeramTec components)
Encore Medical (encoremed.com)
Keramos Acetabular System (using alumina ceramic
heads and liners)
Hayes Medical
(hayesmed.com)
Zirconia and alumina ceramic heads
Smith & Nephew
(smith-nephew.com)
Reflection Ceramic Acetabular System
Stryker
(stryker.com)
C-Taper alumina ceramic femoral heads
V40 alumina ceramic femoral heads
Trident Ceramic Acetabular System
Wright Medical
Technology (wmt.com)
Lineage
alumina ceramic heads
Lineage
ceramic liners
Transcend
Ceramic Hip Articulation System
Effective
October 1, 2006, code 00.77 has been added to capture ceramic-on-polyethylene
bearing surface. The same brand name ceramic heads listed under 00.76 and the
same brand name polyethylene liners listed under 00.74 would apply to this new
code. Smith & Nephew has developed a
new hybrid femoral head component made of oxinium, a zirconium metal alloy base
treated with oxygen to create a ceramic bearing surface of zirconium
oxide. The oxinium femoral head can be
combined with the company's Reflection XLPE to provide another example of a
ceramic-on-polyethylene bearing surface.
Coders should bear
in mind that the above list is not intended to be exhaustive, but merely to
serve as a general reference describing what bearing surfaces are currently
available. In addition to the manufacturers’
websites mentioned above, coders should regularly consult activejoints.com,
a site that keeps track of the latest orthopedic components to receive FDA
approval or to be involved in ongoing clinical trials. Totaljoints.info is another valuable
website featuring helpful discussions of joint replacement components and the
relative benefits and drawbacks of each of the materials currently in use.