2025 CPT code 33949
(Active) Effective Date: N/A Surgery - Surgical Procedures on the Cardiovascular System Feed
Daily management of extracorporeal membrane oxygenation (ECMO) or extracorporeal life support (ECLS), veno-arterial, each day.
Modifiers may be applicable to indicate specific circumstances of the service.
VA ECMO is medically necessary when a patient's heart and lungs are unable to function adequately on their own, requiring temporary life support to allow for recovery. Documentation should support the severity of the condition and the rationale for VA ECMO.
The physician is responsible for the daily management and oversight of the patient on VA ECMO, including monitoring, adjustments, and assessment of the patient's overall health and the ECMO circuit function.
In simple words: This code covers the doctor's daily care for a patient on a heart-lung bypass machine (VA ECMO). This type of life support helps both the heart and lungs. The doctor checks the patient every day, making sure the machine is working correctly and adjusting it as needed.They also monitor the patient's overall health, checking for infections, making sure they're getting the right fluids and medications, and keeping an eye on their blood levels.
This code encompasses the daily physician management of a veno-arterial (VA) ECMO or ECLS circuit.VA ECMO provides both heart and lung support, returning blood from the venous system to the arterial system. It involves daily assessment, monitoring of ventilator settings, positional changes, endotracheal suctioning, review of chest X-rays and lab tests, monitoring of perfusion, intravascular volume, and neurologic status.Management also includes oversight of hemoglobin, platelet levels, clotting times, infection control, fluid and electrolyte balance, and medication levels.This code is reported for each day of VA ECMO management.
Example 1: A patient with severe heart failure requiring both heart and lung support is placed on VA ECMO. Code 33949 is reported daily for the physician's management of the ECMO circuit and patient., A newborn with respiratory distress syndrome is placed on VA ECMO.Code 33949 is reported daily for the physician managing the ECMO., A patient with ARDS following pneumonia is placed on VA ECMO. The physician manages the ECMO circuit and associated care daily. Code 33949 is reported for each day of management.
Documentation should support the medical necessity of VA ECMO, the daily management of the ECMO circuit by the physician, including adjustments, monitoring, and patient assessment, as well as any complications or interventions performed.