In simple words: The doctor removes a tube from a vein or the heart used for a heart-lung machine in a child over six. This is done by making an incision in the chest.The machine helps the heart and lungs rest and recover.

This CPT code, 33986, encompasses the surgical removal of central cannula(e) used for extracorporeal circulation (ECMO/ECLS).The procedure is performed through an open sternotomy or thoracotomy approach and is specifically for patients six years of age and older.The physician removes the cannula(e) from the vein and/or atrium, after which the incision is closed with sutures. This code does not include the initial placement of the cannula(e) or the management of the ECMO/ECLS circuit.It is distinct from the daily management of the patient on ECMO/ECLS which would be coded separately using other relevant Evaluation and Management codes.

Example 1: A 7-year-old child is successfully weaned off ECMO support after treatment for respiratory failure.The physician performs a sternotomy to remove the jugular vein cannula., An 8-year-old patient recovering from cardiac surgery requires removal of a central venous cannula placed for ECMO support during the procedure. A thoracotomy is performed for cannula removal., A 10-year-old patient, post-ECMO for severe pneumonia, needs removal of the cannulae.The physician utilizes a sternotomy approach for access and removal of the central venous cannulae.

* Preoperative diagnosis and indication for ECMO/ECLS.* Operative report detailing the procedure, including the approach used (sternotomy or thoracotomy), location of the cannula(e), and details about removal.* Postoperative course and any complications.* Patient's age verification (six years or older).

** This code is specific to the removal of central cannulae; other procedures may require additional codes depending on the clinical context and the procedures undertaken.