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2025 CPT code 33947

Initiation of extracorporeal membrane oxygenation (ECMO) or extracorporeal life support (ECLS), veno-arterial.

This code is reported only once per initiation of VA ECMO, regardless of the number of cannulae used or the complexity of the procedure.

Modifiers may be applicable in certain circumstances, such as reduced services (modifier 52) or discontinued procedures (modifier 53).However, modifier 63 is not allowed with this code.

Medical necessity for VA ECMO is established by the presence of life-threatening cardiac and/or respiratory failure refractory to conventional treatment.The specific diagnosis leading to the need for ECMO should be clearly documented.

The physician is responsible for the entire initiation process, including cannula placement, circuit setup, parameter adjustments, and patient monitoring during initiation.They must possess specialized training and expertise in ECMO/ECLS procedures.

IMPORTANT:Do not report 33947 in conjunction with 33948, 33949, 33957, 33958, 33959, 33962, 33963, 33964. Do not report modifier 63 with this code.

In simple words: The doctor sets up and starts a heart-lung bypass machine to help both the heart and lungs. This involves choosing the right equipment, adjusting blood flow, and setting other important controls.

This code describes the physician's work involved in initiating veno-arterial ECMO or ECLS.It includes determining the necessary device components, setting blood flow and gas exchange parameters, and other necessary parameters to manage the circuit.This method is used to support both heart and lung function.

Example 1: A patient presents with severe heart failure following a myocardial infarction.The physician decides to initiate VA ECMO to stabilize the patient and allow the heart to recover.The physician places the cannulae, initiates the ECMO circuit, and sets the appropriate parameters., A newborn with persistent pulmonary hypertension requires respiratory and cardiac support. The physician initiates VA ECMO via cannulation, sets up the circuit, and monitors the patient's response., A patient in post-cardiothoracic surgery develops cardiogenic shock.VA ECMO is initiated to support the patient while further interventions are planned.The physician oversees cannulation, circuit initiation, and parameter adjustment.

Documentation should include the medical necessity for ECMO, the cannulation sites, the type of ECMO circuit used (VA), the initial parameters set, the patient's response to the procedure, and any complications encountered.

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