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2025 CPT code 33984

Removal of peripheral (arterial and/or venous) cannula(e) for extracorporeal membrane oxygenation (ECMO)/extracorporeal life support (ECLS), open approach, in patients 6 years and older.

This code should not be reported on the same day as initiation services (33946, 33947) or repositioning services (33957, 33958, 33959, 33962, 33963, 33964).

Modifiers may be applicable depending on the circumstances of the service (e.g., 51 for multiple procedures, 59 for distinct procedural services).

Medical necessity is established by the patient's clinical condition requiring ECMO/ECLS support.Documentation should clearly demonstrate the need for ECMO/ECLS and the successful weaning off the device, justifying the decannulation procedure.

The clinical responsibility includes pre-operative preparation, anesthesia administration (if applicable), surgical access to the cannulation site, careful removal of the cannula, hemostasis, and wound closure.Post-operative monitoring may be indicated depending on the patient's condition.

IMPORTANT:For patients from birth to five years of age, use code 33969.If cannula(e) are removed from one vessel and new cannula(e) are placed in a different vessel, report the appropriate cannula 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: The doctor removes a tube (cannula) from an artery or vein in a child six years or older. This tube was used for a heart and/or lung support machine (ECMO/ECLS). The doctor makes a small cut, removes the tube, and then closes the cut with stitches.

This CPT code, 33984, signifies the removal of peripheral arterial and/or venous cannula(e) utilized in extracorporeal membrane oxygenation (ECMO) or extracorporeal life support (ECLS). The procedure is performed via an open surgical approach on patients aged six years or older.The physician accesses the cannula, cleans the insertion site (e.g., femoral artery or vein), carefully removes the cannula, and then closes the incision using sutures. This code is distinct from the initiation, management, or cannulation of the ECMO/ECLS circuit itself and should not be reported on the same day as initiation codes (33946 or 33947) or repositioning codes (33957-33959, 33962-33964).

Example 1: A 7-year-old child with severe respiratory failure requiring ECMO support for 10 days.After successful weaning, code 33984 is used for the open surgical removal of the venous cannula., An 8-year-old patient on veno-arterial ECMO following cardiac surgery. Once stable, both arterial and venous cannulae are removed using an open surgical technique, coded as 33984., A 12-year-old with respiratory distress syndrome receiving ECMO support.After stabilization, open surgical decannulation is performed; code 33984 is applied.

Operative report detailing the surgical technique (open approach), cannula location (arterial and/or venous), hemostasis, and wound closure.Preoperative and postoperative assessments, including vital signs, laboratory data (e.g., coagulation studies), and imaging (if applicable).

** Fluoroscopic guidance, if used for cannula removal, is included in the procedure and should not be separately reported.Replacement of cannula(e) in the same vessel should be reported using the insertion code, not the removal code. If the cannula is replaced in a different vessel, both removal and insertion codes are reported.

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