November 17, 2016
In a recent case review you performed for us, you reported CPT code 11981-51 (Insertion, non-biodegradable drug delivery implant) when our physician removed an infected hip prosthesis and placed a non-biodegradable antibiotic-impregnated cement spacer as part of a multi-stage revision. We had not used this code in the past because the prosthesis removal code, 27091, includes the text “with or without insertion of spacer.” Can you explain this further?
You are correct that the definition of 27091 refers to placement of a spacer. We are able to report 11981 in addition to the prosthesis removal code because the spacer is incorporating the non-biodegradable antibiotic drug that is used to treat the patient’s infection. Refer to CPT codes 11981, 11982, and 11983 for the CPT insertion, removal, and exchange codes for non-biodegradable drug delivery implant. Remind the physicians to reference the non-biodegradable antibiotic-impregnated cement in the operative note, as placement of biodegradable drug-delivery devices is not separately reportable.
*This response is based on the best information available as of 11/17/16.