Remoção de prótese e inserção de espaçador

por amaral bernardo Qui 18 Jul 2019, 06:23

"Como codificar os procedimentos a que foi submetido este doente com prótese total do joelho direito infetada que codifiquei como T84.53XA:
- Extração do componente femoral e tibial
- Colocação de espaçador biomet ?"

(Responde Fernando Lopes)

A dúvida que se coloca tem a ver com a existência na tabela 0SP Removal Lower Joints das body parts
C Knee Joint, Right
D Knee Joint, Left,
que poderiam codificar a prótese completa, e
T Knee Joint, Femoral Surface, Right,
U Knee Joint, Femoral Surface, Left,
V Knee Joint, Tibial Surface, Right e
W Knee Joint, Tibial Surface, Left
as quais, juntamente com o qualifier C Patellar Surface, permitem codificar os componentes individualmente.

A este respeito diz o Coding Clinic Fourth Quarter 2016 p.110:

Previously, removal of a hip or joint prosthesis was coded to generic body part values for the joint. However, some patients have only a partial joint replacement with a prosthesis at only one anatomic site within the joint. Also, even in a total joint replacement, not all components of the prosthesis are removed or revised. When components are removed or revised, the new body part and qualifier values allow identification of which components were addressed.

Assim sendo, faz sentido codificar os componentes individualmente:

0SPT0JZ  Removal of Synthetic Substitute from Right Knee Joint, Femoral Surface, Open Approach
0SPV0JZ  Removal of Synthetic Substitute from Right Knee Joint, Tibial Surface, Open Approach
0SHC08Z  Insertion of Spacer into Right Knee Joint, Open Approach

Seg	Ter	Qua	Qui	Sex	Sáb	Dom
				1	2	3
4	5	6	7	8	9	10
11	12	13	14	15	16	17
18	19	20	21	22	23	24
25	26	27	28	29	30