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

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.