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Official Description

Arthroscopy, hip, surgical; with acetabuloplasty (ie, treatment of pincer lesion)

© Copyright 2025 American Medical Association. All rights reserved.

Common Language Description

An acetabuloplasty is a surgical procedure performed through arthroscopy to address damage to the acetabulum, which is the socket of the hip joint. This damage is often a result of femoroacetabular impingement, a condition characterized by abnormal contact and friction between the femoral head (the ball) and the acetabulum. Within this context, a specific type of lesion known as a pincer lesion can occur. Pincer lesions are identified when the acetabulum extends excessively over the femoral head, typically at the anterior superior rim of the acetabulum. This over-coverage leads to the labrum, a cartilage structure that provides stability and flexibility to the hip joint, being pinched between the acetabular rim and the femoral head and neck. The procedure involves making small incisions to introduce an arthroscope and surgical instruments, allowing for a minimally invasive approach to visualize and treat the affected area. The surgical steps include examining the hip joint, debriding damaged cartilage, smoothing the articular surface, and creating microfractures to promote new cartilage growth, ultimately aiming to restore normal function and alleviate pain in the hip joint.

© Copyright 2025 Coding Ahead. All rights reserved.

1. Indications

The procedure of acetabuloplasty is indicated for patients experiencing symptoms related to femoroacetabular impingement, particularly those with pincer lesions. The following conditions may warrant this surgical intervention:

  • Pincer Lesion - This condition occurs when the acetabulum extends excessively over the femoral head, leading to pinching of the labrum and resulting in pain and limited range of motion.
  • Hip Pain - Patients may present with chronic hip pain that is exacerbated by certain movements, particularly those involving flexion and rotation of the hip.
  • Limited Range of Motion - Individuals may experience a decreased ability to move the hip joint freely, impacting daily activities and overall quality of life.
  • Labral Tears - Damage to the labrum, which can occur as a result of the impingement, may also necessitate surgical intervention to restore hip function.

2. Procedure

The acetabuloplasty procedure involves several key steps to effectively treat the pincer lesion and restore hip joint function:

  • Step 1: Portal Incision - A small portal incision is made on the lateral aspect of the hip joint to allow for the introduction of the arthroscope. This minimally invasive approach helps reduce recovery time and complications.
  • Step 2: Introduction of Surgical Instruments - A second small incision is created over the anterolateral aspect of the hip joint for the introduction of surgical instruments. Additional incisions may be made as necessary to enhance visualization and access to the hip joint structures.
  • Step 3: Joint Distension - Using fluoroscopic guidance, a catheter is inserted into the hip joint through the lateral incision. Sterile saline is then introduced to distract the joint, providing better access for the surgical procedure.
  • Step 4: Arthroscopic Examination - The catheter is withdrawn, and the arthroscope is introduced into the joint. The surgeon examines the hip joint to assess the extent of the pincer lesion and any associated damage.
  • Step 5: Debridement and Reshaping - Damaged acetabular cartilage is debrided, and the articular surface is smoothed and reshaped to alleviate the impingement and restore normal joint function.
  • Step 6: Microfracture Technique - Microfractures are created in the acetabulum to stimulate the growth of new cartilage, promoting healing and recovery of the joint.
  • Step 7: Closure - Upon completion of the procedure, the arthroscope is removed, the joint is flushed with sterile saline to clear any debris, and the portal incisions are closed to facilitate healing.

3. Post-Procedure

After the acetabuloplasty procedure, patients can expect a recovery period that may involve pain management and rehabilitation. Post-operative care typically includes monitoring for any signs of complications, such as infection or excessive swelling. Patients are often advised to engage in physical therapy to restore strength and range of motion in the hip joint. The duration of recovery can vary based on individual factors, but many patients can gradually return to normal activities within a few weeks, depending on the extent of the surgery and their overall health status. Follow-up appointments are essential to assess healing and ensure the successful outcome of the procedure.

Short Descr HIP ARTHRO ACETABULOPLASTY
Medium Descr ARTHROSCOPY HIP W/ACETABULOPLASTY
Long Descr Arthroscopy, hip, surgical; with acetabuloplasty (ie, treatment of pincer lesion)
Status Code Active Code
Global Days 090 - Major Surgery
PC/TC Indicator (26, TC) 0 - Physician Service Code
Multiple Procedures (51) 3 - Special payment adjustment rules for multiple endoscopic procedures apply.
Bilateral Surgery (50) 1 - 150% payment adjustment for bilateral procedures applies.
Physician Supervisions 09 - Concept does not apply.
Assistant Surgeon (80, 82) 2 - Payment restriction for assistants at surgery does not apply to this procedure...
Co-Surgeons (62) 1 - Co-surgeons could be paid, though supporting documentation is required...
Team Surgery (66) 0 - Team surgeons not permitted for this procedure.
Endoscopic Base Code 29860  Arthroscopy, hip, diagnostic with or without synovial biopsy (separate procedure)
Diagnostic Imaging Family 99 - Concept Does Not Apply
APC Status Indicator Hospital Part B services paid through a comprehensive APC
ASC Payment Indicator Non office-based surgical procedure added in CY 2008 or later; payment based on OPPS relative payment weight.
Type of Service (TOS) 2 - Surgery
Berenson-Eggers TOS (BETOS) P8A - Endoscopy - arthroscopy
MUE 1
CCS Clinical Classification 153 - Hip replacement, total and partial
22 Increased procedural services: when the work required to provide a service is substantially greater than typically required, it may be identified by adding modifier 22 to the usual procedure code. documentation must support the substantial additional work and the reason for the additional work (ie, increased intensity, time, technical difficulty of procedure, severity of patient's condition, physical and mental effort required). note: this modifier should not be appended to an e/m service.
51 Multiple procedures: when multiple procedures, other than e/m services, physical medicine and rehabilitation services or provision of supplies (eg, vaccines), are performed at the same session by the same individual, the primary procedure or service may be reported as listed. the additional procedure(s) or service(s) may be identified by appending modifier 51 to the additional procedure or service code(s). note: this modifier should not be appended to designated "add-on" codes (see appendix d).
58 Staged or related procedure or service by the same physician or other qualified health care professional during the postoperative period: it may be necessary to indicate that the performance of a procedure or service during the postoperative period was: (a) planned or anticipated (staged); (b) more extensive than the original procedure; or (c) for therapy following a surgical procedure. this circumstance may be reported by adding modifier 58 to the staged or related procedure. note: for treatment of a problem that requires a return to the operating/procedure room (eg, unanticipated clinical condition), see modifier 78.
59 Distinct procedural service: under certain circumstances, it may be necessary to indicate that a procedure or service was distinct or independent from other non-e/m services performed on the same day. modifier 59 is used to identify procedures/services, other than e/m services, that are not normally reported together, but are appropriate under the circumstances. documentation must support a different session, different procedure or surgery, different site or organ system, separate incision/excision, separate lesion, or separate injury (or area of injury in extensive injuries) not ordinarily encountered or performed on the same day by the same individual. however, when another already established modifier is appropriate it should be used rather than modifier 59. only if no more descriptive modifier is available, and the use of modifier 59 best explains the circumstances, should modifier 59 be used. note: modifier 59 should not be appended to an e/m service. to report a separate and distinct e/m service with a non-e/m service performed on the same date, see modifier 25.
78 Unplanned return to the operating/procedure room by the same physician or other qualified health care professional following initial procedure for a related procedure during the postoperative period: it may be necessary to indicate that another procedure was performed during the postoperative period of the initial procedure (unplanned procedure following initial procedure). when this procedure is related to the first, and requires the use of an operating/procedure room, it may be reported by adding modifier 78 to the related procedure. (for repeat procedures, see modifier 76.)
79 Unrelated procedure or service by the same physician or other qualified health care professional during the postoperative period: the individual may need to indicate that the performance of a procedure or service during the postoperative period was unrelated to the original procedure. this circumstance may be reported by using modifier 79. (for repeat procedures on the same day, see modifier 76.)
80 Assistant surgeon: surgical assistant services may be identified by adding modifier 80 to the usual procedure number(s).
82 Assistant surgeon (when qualified resident surgeon not available): the unavailability of a qualified resident surgeon is a prerequisite for use of modifier 82 appended to the usual procedure code number(s).
AQ Physician providing a service in an unlisted health professional shortage area (hpsa)
AS Physician assistant, nurse practitioner, or clinical nurse specialist services for assistant at surgery
CC Procedure code change (use 'cc' when the procedure code submitted was changed either for administrative reasons or because an incorrect code was filed)
GC This service has been performed in part by a resident under the direction of a teaching physician
LT Left side (used to identify procedures performed on the left side of the body)
RT Right side (used to identify procedures performed on the right side of the body)
SG Ambulatory surgical center (asc) facility service
X4 Episodic/focused services: for reporting services by clinicians who provide focused care on particular types of treatment limited to a defined period and circumstance; the patient has a problem, acute or chronic, that will be treated with surgery, radiation, or some other type of generally time-limited intervention; reporting clinician service examples include but are not limited to, the orthopedic surgeon performing a knee replacement and seeing the patient through the postoperative period
XU Unusual non-overlapping service, the use of a service that is distinct because it does not overlap usual components of the main service
Date
Action
Notes
2013-01-01 Changed Guideline information changed.
2011-01-01 Added Added
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