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Official Description

Formation of direct or tubed pedicle, with or without transfer; trunk

© Copyright 2025 American Medical Association. All rights reserved.

Common Language Description

The CPT® Code 15570 refers to the formation of a direct or tubed pedicle flap, which can be performed with or without the transfer of the flap to another site on the trunk. A pedicle flap is a type of surgical procedure that involves creating a full-thickness flap of tissue that remains attached to its original blood supply at the donor site. This technique is particularly useful for covering non-adjacent defects, as it allows for the transfer of healthy tissue to areas that require reconstruction. In the case of a direct pedicle flap, the flap is developed and immediately transferred to the recipient site during the same surgical session, with the donor site being approximated to the recipient site to facilitate healing. Conversely, a tubed pedicle flap involves sewing the lateral edges of the flap together to form a tube, which is then transferred to the recipient site. The procedure includes determining the size and configuration of the flap, incising the donor site, and raising a full-thickness flap, which is then sutured to the recipient site in multiple layers. After the flap is secured, the donor site is closed with sutures. In some cases, a separately reportable skin graft or local flap may be necessary to adequately close the donor site. This code is specifically used for the transfer of a flap to the trunk or for the formation of a tubed flap on the trunk that will be transferred to another site later.

© Copyright 2025 Coding Ahead. All rights reserved.

1. Indications

The procedure associated with CPT® Code 15570 is indicated for various conditions where tissue reconstruction is necessary. The following are the explicitly provided indications for performing this procedure:

  • Non-adjacent defects - This procedure is utilized to cover areas of tissue loss or damage that are not directly adjacent to the donor site, allowing for effective reconstruction.
  • Reconstruction needs on the trunk - It is specifically indicated for reconstructive efforts on the trunk, where healthy tissue is required to restore function or appearance.

2. Procedure

The procedure for CPT® Code 15570 involves several critical steps that ensure the successful creation and transfer of a pedicle flap. The following procedural steps are outlined:

  • Step 1: Flap Design - The surgeon begins by determining the appropriate size and configuration of the flap based on the specific needs of the recipient site. This planning is crucial to ensure that the flap will adequately cover the defect and maintain its blood supply.
  • Step 2: Incision of the Donor Site - Once the flap design is established, the donor site is incised. This incision is made carefully to preserve the underlying blood vessels that will supply the flap.
  • Step 3: Raising the Flap - A full-thickness flap is then raised from the donor site. This involves carefully dissecting the tissue to ensure that it remains attached to its vascular supply, which is essential for the flap's viability.
  • Step 4: Transfer to Recipient Site - The flap is then transferred to the recipient site. In the case of a direct pedicle flap, this transfer occurs during the same surgical session, with the donor site approximated to the recipient site to facilitate healing.
  • Step 5: Suturing the Flap - The flap is sutured to the recipient site in multiple layers to ensure stability and proper healing. This layered approach helps to secure the flap and minimize complications.
  • Step 6: Closure of the Donor Site - Finally, the donor site is closed with sutures. In some instances, if the donor site cannot be adequately closed, a separately reportable skin graft or local flap may be required to achieve closure.

3. Post-Procedure

After the completion of the procedure associated with CPT® Code 15570, post-procedure care is essential for optimal recovery. Patients are typically monitored for any signs of complications, such as infection or flap failure. The area where the flap was transferred will require careful observation to ensure proper healing and integration of the flap. Follow-up appointments are necessary to assess the healing process and to manage any potential issues that may arise. Additionally, instructions regarding wound care, activity restrictions, and signs of complications will be provided to the patient to support a successful recovery.

Short Descr SKIN PEDICLE FLAP TRUNK
Medium Descr FRMJ DIRECT/TUBED PEDICLE W/WO TRANSFER TRUNK
Long Descr Formation of direct or tubed pedicle, with or without transfer; trunk
Status Code Active Code
Global Days 090 - Major Surgery
PC/TC Indicator (26, TC) 0 - Physician Service Code
Multiple Procedures (51) 2 - Standard payment adjustment rules for multiple procedures apply.
Bilateral Surgery (50) 0 - 150% payment adjustment for bilateral procedures does NOT apply.
Physician Supervisions 09 - Concept does not apply.
Assistant Surgeon (80, 82) 1 - Statutory payment restriction for assistants at surgery applies to this procedure...
Co-Surgeons (62) 0 - Co-surgeons not permitted for this procedure.
Team Surgery (66) 0 - Team surgeons not permitted for this procedure.
Diagnostic Imaging Family 99 - Concept Does Not Apply
APC Status Indicator Procedure or Service, Multiple Reduction Applies
ASC Payment Indicator Surgical procedure on ASC list in CY 2007; payment based on OPPS relative payment weight.
Type of Service (TOS) 2 - Surgery
Berenson-Eggers TOS (BETOS) P5A - Ambulatory procedures - skin
MUE 2
CCS Clinical Classification 172 - Skin graft

This is a primary code that can be used with these additional add-on codes.

20701 Add-on Code MPFS Status: Active Code APC N Removal of drug-delivery device(s), deep (eg, subfascial) (List separately in addition to code for primary procedure)
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).
Q6 Service furnished under a fee-for-time compensation arrangement by a substitute physician or by a substitute physical therapist furnishing outpatient physical therapy services in a health professional shortage area, a medically underserved area, or a rural area
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.
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.
76 Repeat procedure or service by same physician or other qualified health care professional: it may be necessary to indicate that a procedure or service was repeated by the same physician or other qualified health care professional subsequent to the original procedure or service. this circumstance may be reported by adding modifier 76 to the repeated procedure or service. note: this modifier should not be appended to an e/m service.
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).
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)
XS Separate structure, a service that is distinct because it was performed on a separate organ/structure
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 Short Descriptor changed.
1992-01-01 Added First appearance in code book in 1992.
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