How To Use CPT Code 33965

CPT 33965 describes the removal of peripheral cannula(e) in children from birth through five years of age for extracorporeal membrane oxygenation (ECMO) or extracorporeal life support (ECLS) provided by a physician. 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 33965?

CPT 33965 is used to describe the removal of peripheral cannula(e) in children from birth through five years of age for ECMO or ECLS provided by a physician. This code specifically applies to the percutaneous removal of the cannula, either through a small incision or directly through the skin.

2. Official Description

The official description of CPT code 33965 is: ‘Extracorporeal membrane oxygenation (ECMO)/extracorporeal life support (ECLS) provided by physician; removal of peripheral (arterial and/or venous) cannula(e), percutaneous, birth through 5 years of age.’

3. Procedure

1. The physician prepares the patient for the procedure, ensuring appropriate anesthesia and sterilization.
2. An incision is made over the peripheral arterial and/or venous cannula.
3. The physician cleans the area around the cannula and carefully removes it from the vessel.
4. The cannula is slowly and gently withdrawn from the patient.
5. The physician closes the incision with sutures.

4. Qualifying circumstances

CPT 33965 is applicable to children from birth through five years of age who require the removal of peripheral cannula(e) for ECMO or ECLS. The procedure must be performed by a physician and involve the percutaneous removal of the cannula(e) through an incision or directly through the skin.

5. When to use CPT code 33965

CPT code 33965 should be used when a physician performs the percutaneous removal of peripheral cannula(e) in children from birth through five years of age for ECMO or ECLS. It is important to ensure that the procedure meets the specific age criteria and involves the removal of cannula(e) through a percutaneous approach.

6. Documentation requirements

To support a claim for CPT 33965, the physician must document the following information:

• Patient’s age and indication for ECMO or ECLS
• Details of the procedure, including the specific cannula(e) removed and the approach used (percutaneous)
• Date and time of the procedure
• Any complications or additional interventions performed
• Signature of the performing physician

7. Billing guidelines

When billing for CPT 33965, ensure that the procedure meets the specific criteria for age and percutaneous removal of peripheral cannula(e) for ECMO or ECLS. It is important to follow the appropriate coding guidelines and documentation requirements. Additionally, consider any specific billing guidelines provided by payers or regulatory bodies.

8. Historical information

CPT 33965 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 the percutaneous removal of peripheral cannulae in a two-year-old child who no longer requires ECMO support.
2. During a procedure, a physician removes the peripheral cannulae from a newborn baby who has successfully completed the ECLS treatment.
3. A five-year-old child undergoes the percutaneous removal of peripheral cannulae by a physician after being weaned off ECMO.
4. A physician performs the removal of peripheral cannulae in a three-year-old child who has recovered from the underlying condition requiring ECMO.
5. After a successful ECLS treatment, a physician removes the peripheral cannulae from a four-year-old child using a percutaneous approach.
6. A physician performs the percutaneous removal of peripheral cannulae in a one-year-old child who has completed the ECMO treatment.
7. During a procedure, a physician removes the peripheral cannulae from a newborn baby who has recovered and no longer requires ECLS support.
8. A two-year-old child undergoes the percutaneous removal of peripheral cannulae by a physician after successful ECMO treatment.
9. A physician performs the removal of peripheral cannulae in a five-year-old child who has completed the ECLS treatment and is ready for discharge.
10. After a successful ECLS treatment, a physician removes the peripheral cannulae from a three-year-old child using a percutaneous approach.