How To Use CPT Code 33959

CPT 33959 describes the repositioning of a peripheral cannula for extracorporeal membrane oxygenation (ECMO) or extracorporeal life support (ECLS) in a child from birth through five years of age. This article will cover the description, procedure, qualifying circumstances, appropriate usage, documentation requirements, billing guidelines, historical information and billing examples.

1. What is CPT Code 33959?

CPT 33959 can be used to describe the repositioning of a peripheral cannula for extracorporeal membrane oxygenation (ECMO) or extracorporeal life support (ECLS) in a child from birth through five years of age. This code is used when a physician repositions the peripheral cannula through an open surgical approach, with the assistance of fluoroscopic guidance if necessary.

2. Official Description

The official description of CPT code 33959 is: ‘Extracorporeal membrane oxygenation (ECMO)/extracorporeal life support (ECLS) provided by physician; reposition peripheral (arterial and/or venous) cannula(e), open, birth through 5 years of age (includes fluoroscopic guidance, when performed).’

3. Procedure

1. The physician accesses the peripheral arterial and/or venous cannula using an open surgical approach.
2. The area around the femoral or other vein or artery is cleaned.
3. The physician repositions the peripheral cannula into the open end of the vessel.
4. Fluoroscopic guidance may be used to assist the physician during the repositioning procedure.
5. The cannula acts as an exit point for oxygen-depleted blood from the body into an external device that acts as an artificial lung or oxygenator.
6. The extracorporeal circulation device actively pumps the blood through the oxygenator, where gas exchange occurs.
7. A heat exchanger warms the blood to body temperature before returning it to the patient through the cannula.
8. The incision is closed with sutures.

4. Qualifying circumstances

CPT 33959 is performed on children from birth through five years of age who require repositioning of a peripheral cannula for extracorporeal membrane oxygenation (ECMO) or extracorporeal life support (ECLS). The procedure is performed by a physician and may include the use of fluoroscopic guidance.

5. When to use CPT code 33959

CPT code 33959 should be used when a physician repositions a peripheral cannula for extracorporeal membrane oxygenation (ECMO) or extracorporeal life support (ECLS) in a child from birth through five years of age. It is important to note that this code is specific to the repositioning of a peripheral cannula and should not be used for other ECMO or ECLS procedures.

6. Documentation requirements

To support a claim for CPT code 33959, the physician must document the following information:

• Patient’s age
• Reason for repositioning the peripheral cannula
• Details of the open surgical approach
• Use of fluoroscopic guidance, if applicable
• Description of the repositioning procedure
• Any complications or additional procedures performed
• Signature of the performing physician

7. Billing guidelines

When billing for CPT code 33959, ensure that the procedure is performed by a physician and involves the repositioning of a peripheral cannula for ECMO or ECLS in a child from birth through five years of age. If fluoroscopic guidance is used, it should be documented and reported accordingly. It is important to follow the specific guidelines provided by the payer and to accurately report the services provided.

8. Historical information

CPT code 33959 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 repositions a peripheral cannula for ECMO in a two-year-old child using an open surgical approach.
2. Using fluoroscopic guidance, a physician repositions a peripheral cannula for ECLS in a newborn.
3. A surgeon performs the repositioning of a peripheral cannula for ECMO in a four-year-old child through an open surgical approach.
4. With the assistance of fluoroscopic guidance, a physician repositions a peripheral cannula for ECLS in a three-year-old child.
5. A pediatric cardiologist repositions a peripheral cannula for ECMO in a five-year-old child using an open surgical approach.
6. Using fluoroscopic guidance, a physician repositions a peripheral cannula for ECLS in a one-year-old child.
7. A surgeon performs the repositioning of a peripheral cannula for ECMO in a newborn through an open surgical approach.
8. With the assistance of fluoroscopic guidance, a physician repositions a peripheral cannula for ECLS in a two-year-old child.
9. A pediatric cardiologist repositions a peripheral cannula for ECMO in a three-year-old child using an open surgical approach.
10. Using fluoroscopic guidance, a physician repositions a peripheral cannula for ECLS in a four-year-old child.