CPT Code 33954 | Description & Clinical Information
CPT 33954 describes the procedure in which the healthcare provider utilizes an open surgical approach to insert a peripheral cannula for extracorporeal circulation in a child who is six years or older.
Official Description
The CPT book defines CPT code 33954 as: “Extracorporeal membrane oxygenation (ECMO)/extracorporeal life support (ECLS) provided by physician; insertion of peripheral (arterial and/or venous) cannula(e), open, 6 years and older”.
Billing Guidelines
It is not appropriate to use CPT codes 33953 and 33954 together with CPT codes 34714, 34715, 34716, 34812, 34820, 34833, and 34834.
To maintain extracorporeal circulation, refer to CPT codes 33946, 33947, 33948, and 33949.
Clinical Information
The procedure described by CPT code 33954 involves a complex process of inserting a cannula into a vein or artery to help oxygenate the blood. This is a necessary treatment for individuals with respiratory disorders or heart conditions that make it difficult for the body to circulate and oxygenate blood properly.
Before the procedure can begin, the patient is appropriately prepped and anesthetized to ensure their comfort and safety. The provider then makes an incision in the skin over the femoral or other vein or artery. To ensure cleanliness, the area around the vessel is cleaned thoroughly.
After the area is properly prepped, the provider inserts a cannula into the open end of the vessel slowly. This tube acts as an exit point for oxygendepleted blood from the body into an external device that acts as an artificial lung or oxygenator. The provider may use fluoroscopic guidance to help guide them during the procedure.
The type of cannula used by the provider will determine how blood returns to the body. With a doublelumen catheter, the blood can return through the same cannula; however, with a singlelumen catheter, the provider must create a means for the return of oxygenated blood. The return cannula is placed through the femoral or another vessel in the same manner as the exit tube.
The provider then uses an extracorporeal circulation device to actively pump the blood through the oxygenator in the external device, where gas exchange occurs. A heat exchanger acts to warm the blood to body temperature before returning the blood to the patient through the cannula. This ensures that the blood that is being returned to the body is adequately oxygenated.
Finally, the provider will close the incision with sutures to prevent infection and promote a speedy recovery for the patient. It is essential that the patient be monitored closely after the procedure to ensure that there are no complications and that they are recovering well.
In conclusion, the CPT 33954 procedure is a complex, but vital treatment for individuals with respiratory or heart conditions that result in difficulty oxygenating blood properly. The insertion of a cannula, the use of an external oxygenator, and the careful monitoring of patients, is essential to ensure that they can recover quickly and safely. The procedure requires skilled and experienced providers, who can manage the process and ensure that patients receive optimal care.
