How To Use CPT Code 33986

CPT 33986 describes the removal of central cannula(e) by sternotomy or thoracotomy in patients six years and older. 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 33986?

CPT 33986 can be used to describe the removal of central cannula(e) through an open sternotomy or thoracotomy approach in patients who are six years and older. This code is used when a healthcare provider removes the central cannula for extracorporeal circulation, which is a procedure that involves bypassing the heart and lungs to provide oxygen and carbon dioxide exchange.

2. Official Description

The official description of CPT code 33986 is: ‘Extracorporeal membrane oxygenation (ECMO)/extracorporeal life support (ECLS) provided by physician; removal of central cannula(e) by sternotomy or thoracotomy, 6 years and older.’

3. Procedure

1. The healthcare provider prepares and anesthetizes the patient.
2. An incision is made over the breastbone or chest.
3. The area around the right jugular vein is cleaned.
4. The previously placed central cannula is removed from the right jugular vein and the heart’s right atrium.
5. The extracorporeal circulation device is no longer needed.
6. The incision is closed with sutures.

4. Qualifying circumstances

Patients who are six years and older and require the removal of central cannula(e) for extracorporeal circulation through a sternotomy or thoracotomy approach are eligible for CPT 33986. The procedure is typically performed when the patient no longer needs the extracorporeal circulation device. The central cannula(e) are removed from the right jugular vein and the heart’s right atrium.

5. When to use CPT code 33986

CPT code 33986 should be used when a healthcare provider performs the removal of central cannula(e) through a sternotomy or thoracotomy approach in patients who are six years and older. It is important to ensure that the patient no longer requires the extracorporeal circulation device before performing this procedure.

6. Documentation requirements

To support a claim for CPT 33986, the healthcare provider must document the following information:

• Patient’s age
• Procedure performed (removal of central cannula(e) by sternotomy or thoracotomy)
• Approach used (sternotomy or thoracotomy)
• Date of the procedure
• Details of the procedure, including any complications or additional steps taken
• Signature of the healthcare provider performing the procedure

7. Billing guidelines

When billing for CPT 33986, ensure that the procedure is performed by a physician and that the patient is six years and older. It is important to note that CPT code 33986 should not be reported in conjunction with code 35211. Additionally, consider the Medicare guidelines for reporting this code, as it may be listed under the Inpatient Only (IPO) list.

8. Historical information

CPT 33986 was added to the Current Procedural Terminology system on January 1, 2015. It has not undergone any updates since its addition. In 2017, it was added to the Inpatient Only (IPO) list for Medicare.

9. Examples

1. A physician removes the central cannula(e) through a sternotomy approach in a 10-year-old patient who no longer requires extracorporeal circulation.
2. A healthcare provider performs the removal of central cannula(e) through a thoracotomy approach in a 7-year-old patient who has successfully completed extracorporeal life support.
3. In a 12-year-old patient, a physician removes the central cannula(e) through a sternotomy approach after the patient’s heart and lungs have regained normal function.
4. A surgeon performs the removal of central cannula(e) through a thoracotomy approach in an 8-year-old patient who has recovered from a severe cardiac condition.
5. In a 9-year-old patient, a healthcare provider removes the central cannula(e) through a sternotomy approach to discontinue extracorporeal membrane oxygenation.
6. A physician performs the removal of central cannula(e) through a thoracotomy approach in a 6-year-old patient who has successfully completed extracorporeal life support.
7. In a 14-year-old patient, a surgeon removes the central cannula(e) through a sternotomy approach after the patient’s heart and lungs have regained normal function.
8. A healthcare provider performs the removal of central cannula(e) through a thoracotomy approach in an 11-year-old patient who has recovered from a severe cardiac condition.
9. In a 13-year-old patient, a physician removes the central cannula(e) through a sternotomy approach to discontinue extracorporeal membrane oxygenation.
10. A surgeon performs the removal of central cannula(e) through a thoracotomy approach in a 15-year-old patient who has successfully completed extracorporeal life support.