Question: How should we code the surgeon’s work for excising an ischial pressure ulcer, including a small portion of infected bone? The surgeon closed the site with a skin flap. Montana Subscriber Answer: The best code choice in this case is 15945 (Excision, ischial pressure ulcer, with skin flap closure; with ostectomy). The removal of a portion of infected bone warrants 15945 instead of 15944 (Excision, ischial pressure ulcer, with skin flap closure), which doesn’t mention the ostectomy. You should also rule out 15941 (Excision, ischial pressure ulcer, with primary suture; with ostectomy (ischiectomy)). Although this code captures the ostectomy, the closure method is primary suture, which doesn’t match your description of the surgeon’s work.