How To Use CPT Code 33955

CPT 33955 describes the insertion of central cannula(e) by sternotomy or thoracotomy in a child from birth through 5 years of age 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 33955?

CPT 33955 is used to describe the insertion of central cannula(e) through a sternotomy or thoracotomy approach in a child from birth through 5 years of age. This procedure is performed by a physician and is part of the extracorporeal membrane oxygenation (ECMO) or extracorporeal life support (ECLS) services. It involves the placement of a central cannula in the right jugular vein and the right carotid artery to establish extracorporeal circulation.

2. Official Description

The official description of CPT code 33955 is: ‘Extracorporeal membrane oxygenation (ECMO)/extracorporeal life support (ECLS) provided by physician; insertion of central cannula(e) by sternotomy or thoracotomy, birth through 5 years of age.’

3. Procedure

1. The physician prepares the patient for the procedure and administers anesthesia.
2. An incision is made over the breastbone or chest to access the heart.
3. The right jugular vein is cleaned and a central cannula is inserted into the vein, which serves as an exit point for oxygen-depleted blood.
4. A return cannula is placed through the right carotid artery and advanced into the aorta, allowing for the return of oxygenated blood.
5. An extracorporeal circulation device is used to pump the blood through an external device called an oxygenator, where gas exchange occurs.
6. A heat exchanger warms the blood to body temperature before it is returned to the patient through the cannula.
7. The incision is closed with sutures.

4. Qualifying circumstances

CPT 33955 is performed on children from birth through 5 years of age who require extracorporeal membrane oxygenation (ECMO) or extracorporeal life support (ECLS). The procedure involves the insertion of central cannula(e) through a sternotomy or thoracotomy approach. It is typically performed by a physician and requires the use of an extracorporeal circulation device.

5. When to use CPT code 33955

CPT code 33955 should be used when a physician inserts central cannula(e) through a sternotomy or thoracotomy approach in a child from birth through 5 years of age for extracorporeal membrane oxygenation (ECMO) or extracorporeal life support (ECLS). This code should not be used for patients older than 5 years of age or for other procedures involving extracorporeal circulation.

6. Documentation requirements

To support a claim for CPT 33955, the physician must document the following information:

• Patient’s age
• Procedure performed (insertion of central cannula(e) by sternotomy or thoracotomy)
• Approach used (sternotomy or thoracotomy)
• Date of the procedure
• Details of the cannula placement
• Use of extracorporeal circulation device
• Any additional relevant information or complications
• Physician’s signature

7. Billing guidelines

When billing for CPT 33955, ensure that the procedure is performed by a physician and involves the insertion of central cannula(e) through a sternotomy or thoracotomy approach in a child from birth through 5 years of age. There are no specific guidelines regarding reporting CPT 33955 with other codes. It is important to follow the documentation requirements and provide accurate information to support the claim.

8. Historical information

CPT 33955 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.

9. Examples

1. A physician performs a sternotomy and inserts central cannulae in a 3-year-old child for extracorporeal membrane oxygenation (ECMO) support.
2. A surgeon performs a thoracotomy and inserts central cannulae in a newborn for extracorporeal life support (ECLS) due to respiratory failure.
3. A cardiothoracic surgeon performs a sternotomy and inserts central cannulae in a 2-year-old child for extracorporeal membrane oxygenation (ECMO) support following cardiac surgery.
4. A pediatric surgeon performs a thoracotomy and inserts central cannulae in a 4-year-old child for extracorporeal life support (ECLS) during a complex cardiac procedure.
5. A cardiac surgeon performs a sternotomy and inserts central cannulae in a 1-year-old child for extracorporeal membrane oxygenation (ECMO) support after a severe heart failure episode.