General Surgery Coding Alert

Question: Our surgeon performed an ischiectomy during excision of an ischial pressure ulcer and closed the wound with sutures. How should we code the service? Arkansas Subscriber Answer: The correct code for the procedure you describe is 15941 (Excision, ischial pressure ulcer, with primary suture; with ostectomy [ischiectomy]). You have several pressure-ulcer codes to choose from, depending on your surgeon's documentation regarding closure and extent of the procedure For instance: If the surgeon sutured the wound site following decubitus-ulcer excision but hadn't performed an ostectomy, you should report 15940 (Excision, ischial pressure ulcer, with primary suture). If the surgeon performed flap closure rather than suture, you would choose one of the following codes, depending on whether the surgeon excised a bony prominence: 15944 -- Excision, ischial pressure ulcer, with skin flap closure 15945 -- ... with ostectomy 15946 -- Excision, ischial pressure ulcer, with ostectomy, in preparation for muscle or myocutaneous flap or [...]