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ICD-10 Coding Mismatch in Computer and Robotic Assisted Primary Total Hip Arthroplasty.

Eric A Chen1, Mackenzie A Roof1, Katherine A Lygrisse1

  • 1NYU Langone Orthopedic Hospital, NYU Langone Health, New York, NY.

The Journal of Arthroplasty
|August 30, 2021
PubMed
Summary

Coding for computer-navigated and robotic total hip arthroplasty (THA) using ICD-10-PCS has inaccuracies. While precise, coding errors in technology use may impact clinical data integrity for these advanced procedures.

Keywords:
ICD-10codingcomputer navigationroboticstotal hip arthroplasty

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Area of Science:

  • Orthopedic Surgery
  • Medical Coding Systems

Background:

  • The International Statistical Classification of Disease, 10th Revision Procedural Coding System (ICD-10-PCS) offers detailed classification for technologies in total hip arthroplasty (THA).
  • Evolving surgical technologies and coding complexities can introduce inaccuracies in ICD-10-PCS data for THA.

Purpose of the Study:

  • To assess the accuracy of ICD-10-PCS coding for computer-navigated and robotic-assisted THA.
  • To discuss the implications of coding accuracy on clinical data integrity.

Main Methods:

  • Retrospective review of a single institution's arthroplasty database.
  • Analysis of primary computer-navigated and robotic-assisted THAs performed between October 2015 and November 2020.
  • Comparison of surgical records detailing technology use against applied ICD-10-PCS codes.

Main Results:

  • A total of 3721 technology-assisted THAs were reviewed.
  • 87.5% of cases were coded accurately regarding the type of technology used.
  • Common errors included omission of technology codes for navigated THA and dual coding for robotic THA.

Conclusions:

  • ICD-10-PCS provides granular detail for technology-assisted THA but exhibits significant coding inaccuracies.
  • These inaccuracies raise concerns about the integrity and validity of clinical datasets relying solely on ICD-10-PCS for procedural granularity.