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2025 CPT code 33966

Percutaneous removal of peripheral arterial and/or venous cannula(e) used for extracorporeal membrane oxygenation (ECMO) or extracorporeal life support (ECLS) in patients 6 years and older.

Refer to the official CPT® codebook and coding guidelines for the most up-to-date information and specific instructions regarding this code.Ensure proper documentation is present to support the medical necessity of the procedure.

Modifiers may be applicable depending on the circumstances of the service. Consult the CPT manual for guidance on appropriate modifier use.

Medical necessity is established by the patient's need for ECMO/ECLS and the subsequent need for cannula removal once the patient is stable enough to discontinue support.Documentation supporting the medical necessity of the initial ECMO/ECLS therapy should be available.

The physician is responsible for the percutaneous removal of the peripheral cannula(e), including incision, cannula extraction, and wound closure.This does not include the overall patient management or ECMO/ECLS circuit management.

IMPORTANT:Code 33965 is used for patients from birth through five years of age.If cannula(e) are removed from one vessel and new cannula(e) are placed in a different vessel, report the appropriate cannula(e) removal (33965, 33966, 33969, 33984, 33985, 33986) and insertion (33951, 33952, 33953, 33954, 33955, 33956) codes.Extensive repair or replacement of an artery may be additionally reported (e.g., 35266, 35286, 35371, and 35665).

In simple words: This code covers the doctor's work to remove tubes (cannulas) from a patient's blood vessels after a procedure called ECMO or ECLS that helps the heart and lungs work. This is done through a small cut in the skin and is for children aged six and older.

This CPT code reports the physician's service for the percutaneous removal of peripheral arterial and/or venous cannula(e) utilized in extracorporeal membrane oxygenation (ECMO) or extracorporeal life support (ECLS).The procedure involves making a percutaneous incision, accessing the cannula(e) within the vessel, carefully removing them, and closing the incision with sutures. This service is specifically for patients aged six years and older.The code does not encompass the management of the ECMO/ECLS circuit or overall patient care, which are reported separately.

Example 1: A 7-year-old child is successfully weaned from ECMO after treatment for severe pneumonia. The physician performs a percutaneous removal of the femoral arterial and venous cannula(e)., A 12-year-old patient with respiratory failure secondary to cystic fibrosis has completed their ECMO treatment.The physician removes the peripheral cannula(e) via a percutaneous approach., An 18-year-old patient recovering from cardiac surgery requiring ECMO support needs cannula removal. The physician performs a percutaneous removal of the peripheral cannulae.

Detailed operative notes should include the indication for ECMO/ECLS, the type of cannula(e) removed, location of cannulation site, description of the procedure including any complications, and the type of closure used (e.g., sutures, staples).

** Fluoroscopic guidance, if used during the cannula removal, is included in the code and should not be reported separately.Replacement of cannula(e) in the same vessel should be reported only with insertion codes (33951-33956).

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