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2025 CPT code 15937

Excision of a sacral pressure ulcer with ostectomy, preparing the site for muscle/myocutaneous flap or skin graft closure.

Code 15937 should not be reported with codes for the actual flap or graft application. Modifier 59 may be necessary to distinguish the excision from the closure if performed during the same surgical session.

Modifiers may be applicable in certain situations (e.g., 59 for a distinct procedural service).

Medical necessity for 15937 is established by the presence of a sacral pressure ulcer with bone involvement that requires surgical excision to facilitate healing and prevent complications such as infection or further tissue damage. Conservative treatments should have been attempted or deemed unsuitable.

The surgeon performs the excision of the pressure ulcer and the underlying bone, creating a clean wound bed suitable for subsequent closure with a muscle or myocutaneous flap or a skin graft. This involves careful debridement of necrotic tissue and preparation of the surrounding healthy tissue to receive the graft.

IMPORTANT:For muscle/myocutaneous flap closure, use 15734 and/or 15738 in addition to 15936/15937. For split skin graft closure, use 15100 and/or 15101 in addition to 15936/15937.

In simple words: Removal of a pressure sore on the lower back near the tailbone, including the affected bone, to prepare for a skin or muscle graft.This procedure creates a clean wound bed for the graft, which is done in a separate step.

Excision, sacral pressure ulcer, in preparation for muscle or myocutaneous flap or skin graft closure; with ostectomy. This includes the removal of the ulcer and underlying bone in the sacral region, preparing the wound bed for a flap or graft.It does not include the flap or graft application itself.

Example 1: A patient with a stage IV sacral pressure ulcer with exposed bone requires excision and preparation for a myocutaneous flap closure. Code 15937 is used for the excision and ostectomy, and a separate code (15734/15738) would be used for the flap closure itself., A patient has a large sacral pressure ulcer that has failed conservative treatment. The decision is made to excise the ulcer with ostectomy and apply a split-thickness skin graft. Code 15937 covers the excision and ostectomy, with additional codes (15100/15101) for the skin graft application., An elderly patient presents with a deep sacral pressure ulcer involving bone. After debridement and ostectomy, a latissimus dorsi myocutaneous flap is planned for reconstruction. Code 15937 is used for the excision and ostectomy component of the procedure.

Documentation should include the size and location of the ulcer, the extent of bone involvement, the method of excision, and the planned type of closure (flap or graft). Photographs may be helpful. The medical necessity for the procedure should also be documented, including failed conservative treatments and the potential for improved healing and reduced infection risk.

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