Left hip hemiarthroplasty icd 10 pcs

42. Operative Report Left femoral neck fracture PREOPERATIVE DIAGNOSIS: POSTOPERATIVE DIAGNOSIS: Left femoral neck fracture Internal fixation of left femoral neck fracture OPERATION: Synthes 7.3 cannulated screw x3 IMPLANTS: INDICATIONS: The patient is a 63-year-old male who had a fall, sustaining a left femoral neck fracture. He ws admitted to the medicine service and after a lengthy, extensive discussion regarding different treatment opions including surgical and nonsurgical management, he wished to proceed to the operating room for pinning and internal fixation of his left femoral neck fracture. All his questions were answered, and no guarantees were given PROCEDURE: After proper informed consent was obtained, the patient was brought to the preoperative holding area. The proper extremity was identified and marked for surgery. The patient was then taken to the operatrg
a0om, where anesthesia induced a spinal anesthetic. TED hoses were placed on both lower extremitl Alter a appropriate time-out had been performed, the left lower extremity was then placed under traction togn the bone while padding the right lower extremity. A fluoroscopy unit was brought to the field and the hip wa identified and was found to have acceptable reduction in the area following traction. The left lower extremity was then prepped and draped in sterile fashion. After an additional time-out had been performed, an incision was made over the lateral part of the left hip. Sharp and blunt dissection o carried down to the proximal portion of the femur and using a synthes set, three cannulated guideites re then placed across the fracture while correcting for his rotation and alignment of the proximalfemur ll pins were found to have acceptable position and appropriate-size screws. They were then drilled and placed under fluoroscopic assistance. At the completion of the procedure, radiographs were obtained confirming acceptable placement of all hardware without penetration into the joint and all screw heads were past the fracture area. The screws were inserted until they were flush and had appropriate purchase. The images were saved for the patient's chart. The wounds were irrigated with antibiotic solution. The deep fascial layer was closed with # 1 Vicryl suture followed by subcutaneous skin closure with a 2-0 Vicry 5ature, and skin closure with staples. The patient was taken to the recovery room in stable condition after application of a sterile dressing. The patient will return back to the floor for DVT prophylaxis, gait training, and antibiotics
1. Principal Diagnosis (list only do not code) 2. Additional Diagnosis (list if applicable, do not code) 3. Principal Procedure: List and code 4. Secondary Procedures: List and code