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Extracorporeal membrane oxygenation (ECMO) and extracorporeal life support (ECLS) are terms that refer to advanced medical procedures used to provide prolonged heart and lung support for patients whose heart and lungs are severely compromised. These procedures involve the use of a machine that takes over the function of these vital organs by circulating blood outside the body through an artificial lung, where it is oxygenated before being returned to the bloodstream. The process is critical for patients who are unable to maintain adequate oxygenation and perfusion due to various medical conditions. The procedure described by CPT® Code 33965 specifically pertains to the removal of peripheral cannulae, which are tubes inserted into the blood vessels to facilitate this life-sustaining support. This particular code applies to patients from birth through 5 years of age, highlighting the specialized care required for this younger population. The removal of these cannulae must be performed with precision and care to minimize complications, such as bleeding or air embolism, and is typically conducted by a physician in a controlled environment.
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Extracorporeal membrane oxygenation (ECMO) and extracorporeal life support (ECLS) are indicated for patients experiencing severe respiratory or cardiac failure. The following conditions may warrant the use of ECMO/ECLS:
The procedure for the removal of peripheral cannulae in patients receiving ECMO/ECLS support involves several critical steps to ensure safety and effectiveness:
Post-procedure care involves monitoring the patient for any signs of complications, such as bleeding or infection at the cannula site. Continuous assessment of vital signs and hemodynamic stability is essential. The healthcare team should also observe for any signs of air embolism, particularly in patients who were intubated during the procedure. The dressing should be kept clean and dry, and any changes in the wound site should be documented and reported. Follow-up care may include further imaging or interventions if complications arise.
| Short Descr | ECMO/ECLS RMVL PERPH CANNULA | Medium Descr | ECMO/ECLS RMVL OF PERPH CANNULA PERQ BIRTH-5 YRS | Long Descr | 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 | Status Code | Active Code | Global Days | 000 - Endoscopic or Minor Procedure | PC/TC Indicator (26, TC) | 0 - Physician Service Code | Multiple Procedures (51) | 2 - Standard payment adjustment rules for multiple procedures apply. | Bilateral Surgery (50) | 0 - 150% payment adjustment for bilateral procedures does NOT apply. | Physician Supervisions | 09 - Concept does not apply. | Assistant Surgeon (80, 82) | 0 - Payment restriction for assistants at surgery applies to this procedure... | Co-Surgeons (62) | 0 - Co-surgeons not permitted for this procedure. | Team Surgery (66) | 0 - Team surgeons not permitted for this procedure. | Diagnostic Imaging Family | 99 - Concept Does Not Apply | APC Status Indicator | Inpatient Procedures, not paid under OPPS | Type of Service (TOS) | 2 - Surgery | Berenson-Eggers TOS (BETOS) | P2F - Major procedure, cardiovascular-Other | MUE | 1 |
| 51 | Multiple procedures: when multiple procedures, other than e/m services, physical medicine and rehabilitation services or provision of supplies (eg, vaccines), are performed at the same session by the same individual, the primary procedure or service may be reported as listed. the additional procedure(s) or service(s) may be identified by appending modifier 51 to the additional procedure or service code(s). note: this modifier should not be appended to designated "add-on" codes (see appendix d). | 58 | Staged or related procedure or service by the same physician or other qualified health care professional during the postoperative period: it may be necessary to indicate that the performance of a procedure or service during the postoperative period was: (a) planned or anticipated (staged); (b) more extensive than the original procedure; or (c) for therapy following a surgical procedure. this circumstance may be reported by adding modifier 58 to the staged or related procedure. note: for treatment of a problem that requires a return to the operating/procedure room (eg, unanticipated clinical condition), see modifier 78. | 59 | Distinct procedural service: under certain circumstances, it may be necessary to indicate that a procedure or service was distinct or independent from other non-e/m services performed on the same day. modifier 59 is used to identify procedures/services, other than e/m services, that are not normally reported together, but are appropriate under the circumstances. documentation must support a different session, different procedure or surgery, different site or organ system, separate incision/excision, separate lesion, or separate injury (or area of injury in extensive injuries) not ordinarily encountered or performed on the same day by the same individual. however, when another already established modifier is appropriate it should be used rather than modifier 59. only if no more descriptive modifier is available, and the use of modifier 59 best explains the circumstances, should modifier 59 be used. note: modifier 59 should not be appended to an e/m service. to report a separate and distinct e/m service with a non-e/m service performed on the same date, see modifier 25. | GC | This service has been performed in part by a resident under the direction of a teaching physician |
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| 2015-01-01 | Added | Added |
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