Debridement to bone with advancement flap

maddalynni

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Hello,

Could someone help with this:

Debridement to the bone of stage 4 right ischial ulcer 6cm x 8 cm with a 4cm x 4cm ischial osteotomy. Then elevating the semimembranosus and semitendinosus off of the inferior border of the ischium and carrying the dissection deep to the muscle flap so we were able to advance the side flap up into the ischial defect. The advancement flap was 25 cm x 12cm. The apex of the chronic ulcer was debrided down to healthy tissue and was closed in an inverted Y shape. The myocutaneous flap was advanced into the tissue defect.

Do I use 15937 instead of the debridement codes (11044&11047), I know I can't use both. Do I use 14301/14302 codes vs. the 15734 code??

Please help
 

jdibble

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Code 15937 is for Sacral ulcer. Code 15946 is for Ischial. I am not an expert on skin procedures but I would use 15946 with 15734.

Other opinions might be more helpful.
 
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