2025 CPT code 33959
(Active) Effective Date: N/A Revision Date: N/A Surgery - Cardiovascular System Procedures Surgery Feed
Physician-provided repositioning of a central (arterial and/or venous) cannula(e) for ECMO/ECLS via an open surgical approach in children aged birth to 5 years; includes fluoroscopic guidance if performed.
Modifiers may be applicable depending on the circumstances.Consult current modifier guidelines.
Medical necessity for 33959 is established by the need for ECMO/ECLS and the indication for cannula repositioning due to displacement, obstruction, or malpositioning compromising the effectiveness of the extracorporeal circulatory support.This may be due to several factors such as anatomical variations, patient movement, or clotting around the cannula.
The physician is responsible for surgical access to the cannula, careful repositioning to ensure proper blood flow and function of the ECMO/ECLS circuit, and closure of the surgical site.Use of fluoroscopy, when indicated, falls under the physician's responsibility.
In simple words: The doctor moves a tube (cannula) inside a blood vessel in a child under 5 years old to improve the function of an ECMO or ECLS machine. This machine helps the heart and/or lungs work. The doctor may use a live X-ray (fluoroscopy) to guide the process.
This CPT code, 33959, encompasses the physician's services in repositioning central arterial and/or venous cannulae during extracorporeal membrane oxygenation (ECMO) or extracorporeal life support (ECLS) in children from birth to 5 years of age.The procedure involves an open surgical approach to access and reposition the cannulae within the vessel.Fluoroscopic guidance, if utilized, is included in the code.This code is distinct from initiation, daily management, or removal of the cannulae and should not be reported on the same day as those services.
Example 1: A 2-year-old child undergoing ECMO support for severe respiratory distress syndrome requires repositioning of the central venous cannula due to displacement. The physician performs an open surgical repositioning, utilizing fluoroscopic guidance., A 4-year-old post-cardiac surgical patient on ECMO develops kinking of their central arterial cannula, compromising blood flow.The surgeon repositions the cannula via an open approach to restore adequate flow., A newborn with congenital heart disease requires ECMO support. During the initial days of ECMO, the central venous cannula needs repositioning due to malpositioning. An open approach is used under fluoroscopic guidance.
Operative report detailing the surgical approach, cannula repositioning technique, fluoroscopy use (if any), and post-operative assessment.Preoperative and postoperative imaging may be necessary.Patient's age and weight should be documented.
** This code is specific to open surgical repositioning of central cannulae in children aged birth to 5 years.Other codes exist for different approaches (percutaneous), cannula types (peripheral), and age groups.Precise documentation is critical for accurate coding and reimbursement.
- Payment Status: Active
- Modifier TC rule: Not applicable.
- Specialties:Cardiothoracic Surgery, Cardiac Surgery, Pediatric Cardiology, Pediatric Cardiac Surgery, Neonatology, Critical Care Medicine
- Place of Service:Inpatient Hospital, Pediatric Intensive Care Unit (PICU), Neonatal Intensive Care Unit (NICU)