2025 CPT code 33956
Effective Date: N/A Surgery - Surgical Procedures on the Cardiovascular System Feed
Insertion of central cannula(e) for extracorporeal membrane oxygenation (ECMO) or extracorporeal life support (ECLS) by sternotomy or thoracotomy in a patient 6 years or older.
Modifiers may be applicable in certain situations. For instance, modifier 22 might be used for increased procedural services, modifier 59 for a distinct procedural service, and modifier 76 for a repeat procedure by the same physician.
Medical necessity for this procedure must be clearly documented.The patient's condition should be life-threatening and require cardiopulmonary support that cannot be provided by conventional methods. The documentation must support the rationale for ECMO.
The physician is responsible for the entire procedure, including prepping the patient, making the incisions, inserting the cannulae, managing the extracorporeal circulation, and closing the incisions. They must also monitor the patient's condition and manage any complications.
In simple words: This procedure involves inserting tubes into a child's (6 years and older) heart and major blood vessels through an opening in the chest or breastbone.These tubes connect to a machine that acts like an artificial lung, adding oxygen to the blood and removing carbon dioxide. The machine circulates the blood while the child's heart and lungs rest and recover.
This code describes a procedure where a physician inserts a central cannula (tube) through an open approach, either by sternotomy (incision in the breastbone) or thoracotomy (incision in the chest), for extracorporeal circulation in a child six years and older.The cannula is placed in the right jugular vein and advanced to the right atrium of the heart. Another cannula is placed in the right carotid artery and advanced to the aorta. A double-lumen catheter may be used for blood return. This setup allows blood to be pumped out of the body, oxygenated by an external device, and then returned to the body.
Example 1: A 7-year-old child with severe pneumonia requiring ECMO support., A 10-year-old child with heart failure following open-heart surgery requiring ECMO support., A 15-year-old child with acute respiratory distress syndrome (ARDS) requiring ECMO support.
Documentation should include the reason for ECMO, the type of cannulae used, the location of insertion, details of the extracorporeal circulation management, and any complications encountered.Pre- and post-procedure notes, operative reports, and progress notes are also crucial.
** This procedure requires specialized equipment and personnel trained in ECMO management.It is typically performed in a hospital setting with an intensive care unit capable of providing continuous monitoring and support.
- Specialties:Cardiothoracic Surgery, Pediatric Surgery, Critical Care Medicine
- Place of Service:Inpatient Hospital