Coding Ahead
CasePilot
Medical Coding Assistant
Case2Code
Search and Code Lookup Tool
RedactPHI
HIPAA-Compliant PHI Redaction
DetectICD10CM
ICD-10-CM Code Detection
Log in Register free account
1 code page views remaining. Guest accounts are limited to 1 page view. Register free account to get 5 more views.
Log in Register free account

Official Description

Implantation of absorbable mesh or other prosthesis for delayed closure of defect(s) (ie, external genitalia, perineum, abdominal wall) due to soft tissue infection or trauma

© Copyright 2025 American Medical Association. All rights reserved.

Common Language Description

The procedure described by CPT® Code 15778 involves the implantation of absorbable mesh or other prosthetic materials to facilitate the delayed closure of defects that may occur in areas such as the external genitalia, perineum, or abdominal wall. These defects typically arise due to soft tissue infections, such as necrotizing soft tissue infections (NSTI), or as a result of trauma. In cases where there is significant tissue loss, particularly following extensive debridement, the use of absorbable mesh becomes essential for effective closure and healing. The procedure is particularly relevant for patients who present with large defects in the abdominal wall, which may result from severe infections that necessitate the removal of compromised skin, subcutaneous tissue, fascia, and muscle. The implantation of the mesh or prosthetic material is performed using various surgical techniques tailored to the specific defect and its location. These techniques include underlay, onlay, inlay, and wrap-around methods, each designed to provide optimal support and facilitate healing of the affected area. The mesh is carefully shaped and positioned to ensure adequate coverage and stability of the defect, promoting recovery and minimizing complications.

© Copyright 2025 Coding Ahead. All rights reserved.

1. Indications

The procedure is indicated for patients presenting with defects in the external genitalia, perineum, or abdominal wall that require closure due to the following conditions:

  • Necrotizing Soft Tissue Infection (NSTI) - This condition involves severe infections that lead to the destruction of soft tissue, necessitating surgical intervention and debridement.
  • Trauma - Physical injuries that result in significant tissue loss or damage, requiring reconstruction and closure of the affected area.

2. Procedure

The implantation of absorbable mesh or other prosthesis involves several procedural steps, which may vary based on the specific technique employed:

  • Step 1: Preparation of the Defect - The surgical site is prepared by performing a thorough debridement of necrotized tissue, which includes the removal of all compromised skin, subcutaneous tissue, fascia, and muscle. This step is crucial to ensure that only healthy tissue remains for optimal healing.
  • Step 2: Selection and Shaping of the Mesh - An appropriate piece of absorbable mesh or prosthetic material is selected and cut to the desired shape and size to adequately cover the defect. The choice of mesh and its dimensions are determined based on the specific characteristics of the defect.
  • Step 3: Implantation Techniques - The mesh can be implanted using various techniques:
    • Underlay Technique - The mesh is placed deep to the peritoneum or between the peritoneum and the abdominal wall, extending beyond the edges of the defect. It is secured with mattress sutures that pass through the entire thickness of the abdominal wall, ensuring that omentum is placed between the bowel and the prosthesis to prevent complications.
    • Inlay Technique - The mesh is cut to match the size and shape of the defect and is sutured directly to the edges of the defect, providing a snug fit.
    • Onlay Technique - A larger piece of mesh is sutured to the outer surface of the abdominal wall, covering the defect from above.
    • Wrap-Around Technique - Two sheets of mesh are wrapped around the abdominal wall and sutured to each side of the defect using vertical sutures. The opposing medial edges of the mesh are then sutured together to close the defect effectively.

3. Post-Procedure

After the implantation of the mesh or prosthetic material, post-procedure care is essential to ensure proper healing and minimize complications. Patients are typically monitored for signs of infection, proper integration of the mesh, and overall recovery. Follow-up appointments may be scheduled to assess the healing process and to address any concerns that may arise. It is important to provide instructions regarding activity restrictions and wound care to promote optimal recovery.

Short Descr IMPL ABSRB MSH/PRSTH DLY CLS
Medium Descr IMPL ABSRB MESH/PRSTH DLYD CLSR DFCT INFCTJ/TRMA
Long Descr Implantation of absorbable mesh or other prosthesis for delayed closure of defect(s) (ie, external genitalia, perineum, abdominal wall) due to soft tissue infection or trauma
Status Code Active Code
Global Days 000 - Endoscopic or Minor Procedure
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) 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.
Diagnostic Imaging Family 99 - Concept Does Not Apply
APC Status Indicator Inpatient Procedures, not paid under OPPS
Type of Service (TOS) 2 - Surgery
Berenson-Eggers TOS (BETOS) none
MUE 1
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.
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.
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).
52 Reduced services: under certain circumstances a service or procedure is partially reduced or eliminated at the discretion of the physician or other qualified health care professional. under these circumstances the service provided can be identified by its usual procedure number and the addition of modifier 52, signifying that the service is reduced. this provides a means of reporting reduced services without disturbing the identification of the basic service. note: for hospital outpatient reporting of a previously scheduled procedure/service that is partially reduced or cancelled as a result of extenuating circumstances or those that threaten the well-being of the patient prior to or after administration of anesthesia, see modifiers 73 and 74 (see modifiers approved for asc hospital outpatient use).
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.
62 Two surgeons: when 2 surgeons work together as primary surgeons performing distinct part(s) of a procedure, each surgeon should report his/her distinct operative work by adding modifier 62 to the procedure code and any associated add-on code(s) for that procedure as long as both surgeons continue to work together as primary surgeons. each surgeon should report the co-surgery once using the same procedure code. if additional procedure(s) (including add-on procedure(s) are performed during the same surgical session, separate code(s) may also be reported with modifier 62 added. note: if a co-surgeon acts as an assistant in the performance of additional procedure(s), other than those reported with the modifier 62, during the same surgical session, those services may be reported using separate procedure code(s) with modifier 80 or modifier 82 added, as appropriate.
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
GC This service has been performed in part by a resident under the direction of a teaching physician
GZ Item or service expected to be denied as not reasonable and necessary
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
2023-01-01 Added Code added.
Code
Description
Code
Description
CasePilot

Get instant expert-level medical coding assistance.

Ask about:
CPT Codes Guidelines Modifiers Crosswalks NCCI Edits Compliance Medicare Coverage
Example: "What is CPT code 99213?" or "Guidelines for E/M services"