AHA Coding Clinic® for ICD-10-CM and ICD-10-PCS - 2015 Issue 3; Ask the Editor

Endoprosthetic Replacement of Humerus and Tendon Reattachment

A patient was admitted with a comminuted four part fracture of the left proximal humerus with displacement. There is also a tear of the biceps tendon. During surgery, the articular head surface was removed. An endoprosthetic stem was placed with repair of the tuberosity to the stem. Autologous bone grafts from the procedure site were placed and sutures made a solid reattachment of the tuberosity to the shaft and stem. The head was connected to the stem. The rotator cuff and tuberosity were repaired. The bicep tendon was removed from the proximal portion of the superior glenoid tubercle and reattached into soft tissues on the humeral shaft and into the tendinous portion of the pectoralis major. How should this surgery be coded? ...

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