2025 CPT code 15956
(Active) Effective Date: N/A Revision Date: N/A Surgery - Surgical Procedures on the Integumentary System Surgery Feed
Excision of a trochanteric pressure ulcer in preparation for muscle or myocutaneous flap or skin graft closure.
Modifiers may be needed depending on the circumstances of the service. For example, modifier 59 may be used if multiple distinct services are performed, and modifiers -51,-52 or others can be used to adjust the payment value if necessary.
Medical necessity is established by the presence of a significant pressure ulcer on the trochanteric region that is not amenable to simpler wound care methods. The ulcer must be of a size and depth requiring surgical excision prior to closure with a myocutaneous flap or skin graft for optimal healing and function.Documentation must clearly justify the need for surgical excision and preparation, such as failure of conservative treatments.
The surgeon's responsibilities include prepping the patient, making an incision around the ulcer, excising the ulcerated tissue, and preparing the wound bed for a myocutaneous flap or skin graft.This involves creating a clean and healthy base for the subsequent closure procedure.
In simple words: The doctor removes a pressure sore on the hip bone area to get it ready for a skin graft or flap surgery to close the wound. The graft or flap surgery is billed separately.
This CPT code, 15956, describes the excision of a pressure ulcer located on the trochanteric region of the hip.The procedure involves the removal of the ulcerated tissue to prepare the wound bed for subsequent closure using a myocutaneous flap or skin graft.This is a preparatory procedure; the flap or graft application is coded separately.
Example 1: A 70-year-old patient with a large, deep pressure ulcer on their right hip trochanter is scheduled for excision and preparation for a myocutaneous flap. The surgeon excises the necrotic tissue, thoroughly debrides the wound bed, and prepares it for the subsequent flap procedure. Code 15956 is used to bill for the excision and preparation., An 85-year-old patient with a stage IV pressure ulcer on their left hip trochanter requires extensive debridement.After removing all necrotic tissue, the surgeon prepares the wound for a skin graft.This involves cleaning and ensuring a healthy base for graft application.Code 15956 accurately reflects the excision and preparation component., A 65-year-old patient with a moderately sized pressure ulcer on their right hip trochanter undergoes excision and preparation for closure with a rotation flap. The surgeon meticulously excises the ulcer, ensuring all necrotic tissue is removed.The wound is carefully prepared for flap surgery.Code 15956 is used for this excision and preparation stage.
Detailed medical history, including the duration and stage of the pressure ulcer.Preoperative and postoperative photographs of the wound.Operative report detailing the size and depth of the ulcer, the technique used for excision and preparation, and the assessment of the wound bed's suitability for subsequent closure.Pathology report (if applicable).Documentation of any complications or unexpected events during the procedure.
** This code only covers the excision and preparation of the pressure ulcer for the subsequent closure. The actual flap or graft closure procedure is billed separately using the appropriate CPT codes.
- Revenue Code: P5A (AMBULATORY PROCEDURES - SKIN)
- Payment Status: Active
- Specialties:Plastic Surgery, General Surgery
- Place of Service:Inpatient Hospital, Outpatient Hospital, Ambulatory Surgical Center