General Surgery Coding Alert

Question: Our surgeon performed an ischiectomy during excision of an ischial pressure ulcer and closed the wound with sutures. How should we code the service?

Arkansas Subscriber

Answer: The correct code for the procedure you describe is 15941 (Excision, ischial pressure ulcer, with primary suture; with ostectomy [ischiectomy]).

You have several pressure-ulcer codes to choose from, depending on your surgeon's documentation regarding closure and extent of the procedure

For instance: If the surgeon sutured the wound site following decubitus-ulcer excision but hadn't performed an ostectomy, you should report 15940 (Excision, ischial pressure ulcer, with primary suture).

If the surgeon performed flap closure rather than suture, you would choose one of the following codes, depending on whether the surgeon excised a bony prominence:

• 15944 -- Excision, ischial pressure ulcer, with skin flap closure
• 15945 -- ... with ostectomy
• 15946 -- Excision, ischial pressure ulcer, with ostectomy, in preparation for muscle or myocutaneous flap or skin graft closure.

Location leads code choice: If the surgeon treats a decubitus ulcer at a site other than an ischial pressure ulcer, CPT® provides different sets of codes based on the location. For instance, choose between 15920 and 15921 for coccygeal ulcers (Excision, coccygeal pressure ulcer, with coccygectomy; ...)