2025 CPT code 33965
(Active) Effective Date: N/A Revision Date: N/A Surgery - Surgical Procedures on the Cardiovascular System Surgery Feed
Percutaneous removal of peripheral arterial and/or venous cannula(e) for ECMO/ECLS in children (birth through 5 years).
Modifiers may be applicable depending on the circumstances of the service. For example, modifier 51 (multiple procedures) could be used if multiple cannulae are removed during the same session.
Medical necessity for ECMO/ECLS and subsequent cannula removal is determined by the underlying medical condition and the patient's response to treatment.The removal procedure is medically necessary when the patient's condition has improved to the point that ECMO/ECLS is no longer required and the cannula(e) can be safely removed.
The physician is responsible for the safe and effective removal of the peripheral cannula(e). This includes appropriate prepping of the site, making an incision if necessary, removing the cannula(e), and closing the incision. The physician may delegate certain aspects of the procedure to other healthcare professionals under their supervision, but retains ultimate responsibility.
In simple words: This code covers the doctor's work in removing a small tube (cannula) from a child's artery or vein. This tube was used to help the child's heart and/or lungs work while they were sick. The doctor removes the tube through a small opening in the skin.
This CPT code reports the physician's service of percutaneous removal of peripheral arterial and/or venous cannula(e) used in extracorporeal membrane oxygenation (ECMO) or extracorporeal life support (ECLS) for patients aged birth through 5 years.The procedure involves removing the cannula(e) via a percutaneous approach, which may include making a small incision to access the cannula.The code does not include the management of the ECMO/ECLS circuit itself or any other associated patient care.
Example 1: A 2-year-old child on ECMO for respiratory failure has improved lung function and is ready for cannula removal. The physician performs a percutaneous removal of the peripheral venous cannula., A 4-year-old child with congenital heart disease has completed their ECMO support. The physician removes both the peripheral arterial and venous cannula(e) percutaneously., A newborn infant on ECMO for neonatal respiratory distress syndrome shows significant improvement. The physician performs a percutaneous removal of a single peripheral arterial cannula.
Complete medical record with documentation of the indication for ECMO/ECLS, the type of cannula(e) used, the location of the cannula(e), the date and time of cannula insertion and removal, the method of removal (percutaneous), the patient’s age, the type of closure used (if applicable), and any complications encountered during the procedure.Preoperative and postoperative assessments should also be documented.
** This code is specifically for percutaneous removal of peripheral cannulae in children under 6 years of age.Different codes exist for open removal and for patients 6 years and older.
- Payment Status: Active
- Modifier TC rule: Not applicable.
- Specialties:Cardiothoracic Surgery, Pediatric Cardiology, Critical Care Medicine, Neonatology
- Place of Service:Inpatient Hospital, Pediatric Intensive Care Unit, Neonatal Intensive Care Unit