2025 CPT code 15570
(Active) Effective Date: N/A Revision Date: N/A Surgery - Surgical Procedures on the Integumentary System Integumentary System Feed
Formation of a direct or tubed pedicle flap, with or without transfer; trunk.
Modifiers 59 (distinct procedural service) and potentially others may be necessary depending on the complexity of the case and other procedures performed.
The creation of a pedicle flap is medically necessary when a patient has a significant wound or defect that requires coverage with healthy tissue, and when other methods (such as skin grafts) are not feasible or suitable. Proper documentation substantiating the need for flap surgery is essential for reimbursement.
The surgeon is responsible for preparing and creating the pedicle flap, which involves precise incisions, elevation of tissues, and potentially creating a tubular structure (tubed pedicle). If the transfer is done at the same time, the surgeon connects the flap to the recipient site, ensuring appropriate blood supply.Postoperative care is also the surgeon's responsibility.
In simple words: The doctor creates a flap of healthy skin and tissue to cover a wound or injury.This is done using the patient's own skin and the flap is connected to its original location, supplying blood to the new site. This code applies to a flap from the trunk (torso) area.
This CPT code encompasses the creation of a direct or tubed pedicle flap from the patient's healthy skin and tissue.The procedure involves incising and lifting the edges of a skin and tissue section. For a tubed pedicle, the edges are stitched together to create a tube.The flap may be transferred to a recipient site during the same procedure or in a separate procedure (coded separately). The trunk is specified as the donor site location in this instance.The procedure may or may not involve transfer of the flap at the same operative session.
Example 1: A patient presents with a large, full-thickness wound on their abdomen resulting from a motor vehicle accident. The surgeon creates a large tubed pedicle flap from the patient's lower back to cover the wound, leaving the pedicle flap connected to the donor site for nourishment until a later procedure to complete the transfer., A patient has a chronic wound on their flank from a previous surgery that has failed to heal. The surgeon creates a direct pedicle flap from the nearby abdominal region to cover this wound. The flap is directly sutured to the recipient site and the blood supply from the donor site remains intact., A patient with a burn on their chest requires a skin graft but due to the extent of the injury, the surgeon decides to create a tubed pedicle flap on the patient's back to reconstruct the chest wall. The flap is surgically created and will be transferred in a later surgical procedure (coded 15650).
Preoperative assessment including imaging (photography) of the wound and donor site, operative report detailing flap creation and dimensions, donor and recipient site descriptions, intraoperative photographs, pathology reports (if applicable), and postoperative follow-up notes documenting flap viability and healing.
** Accurate documentation of the size and location of the flap, donor and recipient sites, and the type of pedicle (direct or tubed) is crucial for correct coding and reimbursement.Specific details about whether the transfer happened during the same session or was staged must also be clearly noted. Consult with coding specialists for clarification in complex cases.
- Revenue Code: P5A (Ambulatory Procedures - Skin)
- RVU: Data not available.Refer to CMS guidelines and local payer policies for RVU values and reimbursement rates.
- Global Days: Not applicable.
- Payment Status: Active
- Modifier TC rule: Not applicable.
- Fee Schedule: Data not available. Refer to historical CMS fee schedules for relevant data.
- Specialties:Plastic Surgery, General Surgery
- Place of Service:Inpatient Hospital, Ambulatory Surgical Center