2025 CPT code 33951
(Active) Effective Date: N/A Revision Date: N/A Surgery - Surgical Procedures on the Cardiovascular System Surgery Feed
Insertion of peripheral (arterial and/or venous) cannula(e) for extracorporeal membrane oxygenation (ECMO)/extracorporeal life support (ECLS), percutaneous, birth through 5 years; includes fluoroscopic guidance.
Modifiers may be applicable based on the circumstances of the procedure (e.g., modifier 59 for multiple procedures, or other applicable modifiers depending on circumstances). Consult the CPT® modifier guidelines for additional information.
Medical necessity for 33951 is established by the presence of severe cardiopulmonary insufficiency refractory to conventional medical management, requiring ECMO/ECLS support to maintain life.Supporting documentation should demonstrate the failure of less invasive interventions.
The physician is responsible for the percutaneous insertion of the cannula(e), including appropriate site selection, cannulation technique, and ensuring the safe and effective placement of the cannula(e) for initiation of ECMO/ECLS.Fluoroscopic guidance, when used, falls under the physician’s responsibility.
In simple words: This code covers the insertion of small tubes (cannulas) into a child's artery and/or vein to connect them to a machine that does the work of their heart and lungs while they recover. This is done through a tiny opening in the skin, and may use X-ray imaging for guidance.
This CPT code encompasses the percutaneous insertion of peripheral arterial and/or venous cannula(e) to facilitate extracorporeal membrane oxygenation (ECMO) or extracorporeal life support (ECLS) in patients aged birth through 5 years.The procedure includes fluoroscopic guidance, if performed.It is distinct from the initiation, daily management, and discontinuation of ECMO/ECLS (codes 33946-33949).Repositioning of cannulae at the same session as insertion is not separately reportable. Replacement in the same vessel uses the insertion code; if a different vessel is involved, use appropriate removal and insertion codes.
Example 1: A neonate born with severe respiratory distress syndrome requires ECMO support. The physician performs percutaneous insertion of peripheral cannula(e) for initiation of veno-venous ECMO., A 3-year-old child with myocarditis and cardiogenic shock needs veno-arterial ECMO. The physician inserts peripheral cannula(e) under fluoroscopic guidance., A 5-year-old with severe pneumonia and respiratory failure requires ECMO.The physician inserts peripheral venous cannula(e) for veno-venous ECMO.
Detailed operative notes documenting the procedure, including patient age, indication for ECMO/ECLS, type of cannula(e) used, sites of insertion, fluoroscopic guidance (if utilized), and any complications encountered. Pre-operative and post-operative assessments, including hemodynamic parameters, are also required. Imaging reports (if fluoroscopy used) are needed to show proper cannula placement.
** This procedure is highly complex and typically requires a multidisciplinary team.Accurate coding necessitates comprehensive documentation. This procedure is usually done in a hospital setting because of the sophisticated equipment needed.The global period for this procedure is unclear and needs clarification.Always check the most updated CPT guidelines for current coding practices.
- Payment Status: Active
- Modifier TC rule: This code does not typically involve a technical component (TC) modifier.
- Specialties:Cardiothoracic Surgery, Cardiac Anesthesiology, Pediatric Cardiology, Neonatology, Critical Care Medicine
- Place of Service:Inpatient Hospital, Pediatric Intensive Care Unit (PICU), Neonatal Intensive Care Unit (NICU)