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BETA v.3.0

2025 CPT code 33958

Repositioning of a peripheral cannula for extracorporeal membrane oxygenation (ECMO) or extracorporeal life support (ECLS) in patients 6 years and older.

Daily management codes (33948 and 33949) should not be reported on the same day as initiation of ECMO (33946 or 33947).

Modifiers may be applicable to indicate specific circumstances, such as increased procedural services (22) or reduced services (52).

Medical necessity for cannula repositioning must be documented, such as decreased flow, cannula malfunction, or patient discomfort.

The physician performs a percutaneous repositioning of the ECMO/ECLS cannula using fluoroscopic guidance.

IMPORTANT:(Do not report 33957, 33958 in conjunction with 34713)

In simple words: This procedure involves repositioning a tube used for heart and lung support in children older than six.A small cut is made in the skin, and the tube (cannula) is moved to a new position.X-ray imaging helps guide the repositioning.

Extracorporeal membrane oxygenation (ECMO) or extracorporeal life support (ECLS) provided by physician; reposition peripheral (arterial and/or venous) cannula(e), percutaneous, 6 years and older (includes fluoroscopic guidance, when performed)

Example 1: A 10-year-old patient on ECMO support requires repositioning of their arterial cannula due to decreased blood flow., A 70-year-old patient experiencing complications from ECMO therapy needs a venous cannula repositioned under fluoroscopic guidance., A teenager on ECMO support has a cannula repositioned due to discomfort and potential vessel damage.

Documentation should include the medical necessity for the repositioning, details of the procedure, use of fluoroscopy, and any complications encountered.

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