You are watching: Cpt code for removal of hardware

ICD-9Classification / TreatmentEtiology / organic HistoryAssociated Injuries / Differential DiagnosisAnatomyComplicationsClinical EvaluationFollow-up CareXray / Diagnositc TestsReview References


Painful Hardware ICD-9

996.67 Complication as result of internal orthopedic device996.4 (mechanical complication of inner orthopedic device, implant, and graft.996.78(other complications of internal orthopedic an equipment / implant), 996.77(other complication of internal implant/device as result of internal share prosthesis)

Hardware removal CPT

Antibiotic Beads

11981 Insertion, non-biodegradable drug shipment implant11982 Removal, no biodegradable drug shipment implant11983 Removal v reinsertion, non-biodegradable drug shipment implant

Hardware remove Etiology / epidemiology / organic History

Accounts for
5% that orthopaedic procedures

Hardware removed Anatomy

Direct fracture healing: no fracture callus; brand-new osseous channels form across the fracture site; strict fixation; can occur with compression plating.Indirect fracture healing: with callus formation; less rigid fixation; intramedullary or external fixation.

Hardware remove Clinical Evaluation

Hardware remove Xray / Diagnositc Tests

Evaluate xryas for radiographic evidence of circumferential bridging outside callus,

Hardware removal Classification / Treatment

Retain implants because that at least 12 months postoperatively to allow for bone remodeling prior to hardware removal. (Brumback RJ, J Bone joint Surg to be 1992; 74: 106-112.)Achieving finish union and also remodeling before implant removed decreases the threat of refracture.Avoiding unnecessary disruption that the vascular it is provided to the bone reduce osteopenia. Furthermore, permitting sufficient time because that the vascular it is provided to recover may correct the early stage osteopenia.Screw holes may remain as stress risers for as lengthy as 4 months. Ankle Fracture: 75% innovation after hardware removed (Jacobsen S, Foot fishing eye 1994; 15: 170-171).Femoral ns nail: 65% pains relief adhering to femoral intramedullary nail removal (Dodenhoff RM, J Bone joint Surg Br 1997; 79: 738-741).Tibial IM pond hardware removal: 45% rate of complete relief the knee pain after tibial pond removal; 35% the patients experienced partial relief and 20%, no relief. (Keating JF, J Orthop Trauma 1997; 11: 10-13)No patient have to be guaranteed complete pain relief.

Hardware removed Associated Injuries / Differential Diagnosis

NonunionMalunionInfectionHematomaNerve injury

Hardware removed Complications

RefractureContinued pain

Hardware removed Follow-up Care

There is no consensus worrying the crucial amount the protection, weight-bearing limits, or task modification after implant removal.Screw holes existing a stess riser for up to 4 month after screw remove (Rosson J, Injury 1991; 22: 383-384).Consider limiting impact and torsional loading for approximately 4 months after hardware removal.

Review References

Rosson JW, Shearer JR. Refracture after ~ the removal of plates native the forearm. One avoidable complication. J Bone joint Surg Br. 1991 May;73(3):415-7.Deluca PA, lindsay RW, Ruwe PA. Refracture of skeletal of the forearm ~ the removal of compression plates.

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J Bone joint Surg Am. 1988 Oct;70(9):1372-6.Busam ML, JAAOS 2006;14:113