© Copyright 2025 American Medical Association. All rights reserved.
An ischial pressure ulcer, commonly known as a pressure sore, bedsore, or decubitus ulcer, occurs in the lower posterior region of the bony pelvis, specifically over the ischium. This type of ulcer typically develops due to prolonged pressure on the skin, often in individuals who are bedridden or have limited mobility. The procedure described by CPT® Code 15944 involves the surgical excision of the ischial pressure ulcer, which is performed with a skin flap closure technique. During the procedure, the patient is positioned face down to provide optimal access to the affected area. The physician makes an elliptical incision around the ulcer, excising the damaged tissue. Following the excision, the wound is thoroughly irrigated to remove any debris or contaminants. A local skin flap is then utilized to close the wound, which involves incising the skin adjacent to the ulcer down to the level of subcutaneous fat. This allows the skin to be mobilized effectively. The skin flap is subsequently rotated or advanced over the excised area and sutured in place, ensuring proper closure of the wound. Additionally, the donor site from which the skin flap was taken is also repaired with sutures, completing the procedure and promoting healing in the affected area.
© Copyright 2025 Coding Ahead. All rights reserved.
The procedure described by CPT® Code 15944 is indicated for patients presenting with an ischial pressure ulcer that requires surgical intervention. The following conditions may warrant this procedure:
The procedure for excising an ischial pressure ulcer with skin flap closure involves several critical steps:
Post-procedure care for patients who have undergone excision of an ischial pressure ulcer with skin flap closure includes monitoring the surgical site for signs of infection, ensuring proper wound care, and managing pain. Patients may require follow-up visits to assess healing and to change dressings as needed. It is also important to educate patients on pressure relief techniques and repositioning to prevent the recurrence of pressure ulcers. The expected recovery time may vary based on the extent of the ulcer and the patient's overall health status.
| Short Descr | EXC ISCH PR ULC SKN FLP CLSR | Medium Descr | EXC ISCHIAL PRESSURE ULCER W/SKIN FLAP CLOSURE | Long Descr | Excision, ischial pressure ulcer, with skin flap closure; | 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) | 0 - 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 | 170 - Excision of skin lesion |
| 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). | 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.) | 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 | 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) | SA | Nurse practitioner rendering service in collaboration with a physician | XU | Unusual non-overlapping service, the use of a service that is distinct because it does not overlap usual components of the main service |
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| 2025-01-01 | Changed | Short Description changed. |
| 2010-01-01 | Changed | Code description changed. |
| Pre-1990 | Added | Code added. |
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