2025 CPT code 33963
(Active) Effective Date: N/A Surgery - Cardiovascular System Feed
Repositioning of central cannula(e) for extracorporeal membrane oxygenation (ECMO) or extracorporeal life support (ECLS) by sternotomy or thoracotomy in patients birth through 5 years of age.
Modifiers may be applicable to indicate specific circumstances, such as increased procedural services (modifier 22) or multiple procedures (modifier 51).
Medical necessity for repositioning is established when the central cannula is malpositioned, obstructed, or causing complications, compromising the effectiveness of ECMO/ECLS support.
The physician performs the repositioning of the central cannula(e) using a sternotomy or thoracotomy approach, which may include the use of fluoroscopic guidance. The clinical responsibility includes prepping the patient, anesthesia, incision, repositioning the cannula, managing the ECMO/ECLS circuit parameters, and closing the incision.
In simple words: The doctor repositions a tube used for heart-lung bypass during open-heart surgery in a young child (birth through 5 years old).This involves reopening the chest or breastbone area.X-ray guidance may be used.
Extracorporeal membrane oxygenation (ECMO) or extracorporeal life support (ECLS) provided by physician; reposition central cannula by sternotomy or thoracotomy, birth through 5 years of age (includes fluoroscopic guidance, when performed)
Example 1: A 2-year-old patient on ECMO support requires repositioning of the central cannula due to dislodgement. The physician performs a sternotomy to access and reposition the cannula., A newborn infant with respiratory failure requires ECMO. During the course of treatment, the central cannula needs repositioning. The physician performs a thoracotomy to reposition the cannula under fluoroscopic guidance., A 4-year-old child undergoing ECMO for cardiac support requires adjustment of the central cannula position. The physician reopens the previous sternotomy incision and repositions the cannula.
Documentation should include the reason for cannula repositioning, the surgical approach (sternotomy or thoracotomy), use of fluoroscopic guidance (if applicable), and any complications encountered during the procedure.
- Payment Status: Active
- Place of Service:Inpatient Hospital