How To Use CPT Code 33954

CPT 33954 describes the insertion of peripheral (arterial and/or venous) cannula(e) for extracorporeal membrane oxygenation (ECMO) or extracorporeal life support (ECLS) provided by a physician. This article will cover the description, official description, procedure, qualifying circumstances, appropriate usage, documentation requirements, billing guidelines, historical information and billing examples.

1. What is CPT Code 33954?

CPT 33954 can be used to describe the insertion of peripheral cannula(e) for extracorporeal membrane oxygenation (ECMO) or extracorporeal life support (ECLS) provided by a physician. This code is used when the physician inserts a peripheral cannula through an open surgical approach in a child who is six years and older.

2. Official Description

The official description of CPT code 33954 is: ‘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.’

3. Procedure

1. The physician prepares and anesthetizes the patient.
2. An incision is made over the femoral or other vein or artery.
3. The area around the vein or artery is cleaned.
4. A cannula is inserted into the open end of the vessel.
5. The physician may use fluoroscopic guidance for assistance.
6. If a double-lumen catheter is used, the blood may return through the same cannula. If a single-lumen catheter is used, a separate cannula is placed for the return of the oxygenated blood.
7. The extracorporeal circulation device is used to pump the blood through the oxygenator in the external device, where gas exchange occurs.
8. A heat exchanger warms the blood to body temperature before returning it to the patient through the cannula.
9. The incision is closed with sutures.

4. Qualifying circumstances

CPT 33954 is performed on children who are six years and older and require extracorporeal membrane oxygenation (ECMO) or extracorporeal life support (ECLS). The procedure involves the insertion of peripheral cannula(e) through an open surgical approach. It is important to note that CPT 33954 should not be reported in conjunction with certain other codes, such as 34714, 34715, 34716, 34812, 34820, 34833, and 34834. Additionally, for maintenance of extracorporeal circulation, other codes should be used (33946, 33947, 33948, 33949).

5. When to use CPT code 33954

CPT code 33954 should be used when a physician performs the insertion of peripheral cannula(e) for extracorporeal membrane oxygenation (ECMO) or extracorporeal life support (ECLS) in a child who is six years and older. It is important to ensure that the patient meets the age requirement and that the procedure is performed using an open surgical approach.

6. Documentation requirements

To support a claim for CPT 33954, the physician must document the following information:

• Patient’s age (must be six years or older)
• Procedure performed (insertion of peripheral cannula(e) for ECMO/ECLS)
• Specific site of cannula insertion (femoral or other vein/artery)
• Use of fluoroscopic guidance (if applicable)
• Type of cannula used (single-lumen or double-lumen)
• Details of the extracorporeal circulation device and oxygenator used
• Method of blood return (same cannula or separate cannula)
• Incision closure method (suturing)

7. Billing guidelines

When billing for CPT 33954, ensure that the procedure is performed by a physician and that the patient meets the age requirement of six years or older. It is important to note that CPT 33954 should not be reported in conjunction with certain other codes, as mentioned earlier. Additionally, consider the tips provided for reporting CPT 33954 accurately. It is crucial to follow the specific guidelines and requirements of the payer when submitting claims for this procedure.

8. Historical information

CPT 33954 was added to the Current Procedural Terminology system on January 1, 2015. It was later added to the Inpatient Only (IPO) list for Medicare in 2017. There have been no updates to the code since its addition.

9. Examples

1. A physician inserts peripheral cannula(e) for extracorporeal membrane oxygenation (ECMO) in a seven-year-old child.
2. A surgeon performs the insertion of peripheral cannula(e) for extracorporeal life support (ECLS) in a nine-year-old patient.
3. A pediatrician performs the procedure of inserting peripheral cannula(e) for ECMO in a twelve-year-old child.
4. An interventional radiologist inserts peripheral cannula(e) for extracorporeal life support (ECLS) in a fifteen-year-old patient.
5. A cardiothoracic surgeon performs the insertion of peripheral cannula(e) for extracorporeal membrane oxygenation (ECMO) in an eight-year-old child.
6. Provide four more examples of cases in which CPT code 33954 should be billed. Only explain the examples and make them all original. Do not include ‘CPT 33954” or ‘CPT code 33954” in the text of an example.