General Surgery Coding Alert

Question: Are codes 33948 and 33949 the only codes available for ECMO services?

Louisiana Subscriber

Answer: The codes you mentioned describe the daily management of the extracorporeal membrane oxygenation (ECMO) circuit as follows:

• 33948 (Extracorporeal membrane oxygenation (ECMO)/ extracorporeal life support (ECLS) provided by physician; daily management, each day, veno-venous)
• 33949 (… veno-arterial)

But those aren’t the only codes your surgeon might report for ECMO services. CPT^® gives you the following two codes to report initial cannulation and repositioning, removing, or adding of cannula(e) while the ECMO is supporting the patient:

• 33946 (Extracorporeal membrane oxygenation (ECMO)/ extracorporeal life support (ECLS) provided by physician; initiation, veno-venous)
• 33947 (… initiation, veno-arterial)

Remember: A physician must perform codes 33946 and 33947. During these services, the physician will determine the necessary ECMO device components, the blood flow, the gas exchange, and any other necessary parameters to manage the circuit, per CPT^®. That includes oxygenation, CO₂ clearance by the membrane lung, systemic response, anticoagulation, and treatment of bleeding, cannula positioning, alarms, and safety.