Wiki ECMO during global period

[zaida120]

Need some clarification. If a doctor has performed a CABG on a patient and then that patient needs an ECMO I know we can bill for the insertion of the ECMO. Where I am not clear is would it be appropriate to bill for 33960 initial 24 hour prolong extracorporeal circulation when the patient is already under the doctors care for the CABG (global period)?

Thanks for you help!

 

[MLS2]

I am thinking yes...was the ECMO done for a different reason than the CABG? (respiratory failure, etc...)

 

[zaida120]

Yes, patient went into cardiac arrest then respiratory failure. So here's another question, do I use the prolonged ECMO codes or critical care codes? Would it be wrong to go for the higher reimbursement so long as it meets the guidelines. My doctor is documenting time and is stating patientas critical. Or can I bill for both? My mind is spinning on this one

Thanks again for your help!

 

[FTessaBartels]

Critical Care and ECMO

Our cardiac intensivists WILL code for both 99291 and ECMO management 33960-33961 on the same DOS. BUT they are NOT the surgeons who insert the cannulas.

Critical care is an E/M code, andwill be considered global to your procedure if you try to code it for the surgeon.

Hope that helps.

F Tessa Bartels, CPC, CEMC