Wiki ECMO Initiation and Insertion

[venitacason]

Good afternoon,

I am confused on 33946/33947 (Initiation) and 33951-33956 (Insertion).

Are we able to submit an insertion code on the same date as initiation? It would seem logical but I cannot find any footnotes or guidelines to clear my confusion.

Also, what would be the difference between OPEN and TRANSTHORACIC? Wouldn't an insertion of cannula(e) by sternotomy or thoracotomy both be open procedures?

Thank you!
Venita

 

[jbhansen]

Yes if the same provider inserted the cannula(e) and is also managing the ECMO, both initiation and insertion should be billed on the same date. You cannot however bill initiation and repositioning on the same date (but could bill daily management and repositioning on the same date).
Codes 33953-33954, 33959, 33962, 33969, 33984 are for open peripheral cannula(e). These differ from 33955-33956, 33963-33964, 33985-33986 which are for central cannual(e) insertion by sternotomy or thoracotomy, which yes, are also open. The difference being peripheral vs. central.
Essentially there are 3 possible methods: 1) peripheral percutaneous, 2) peripheral open, or 3) central (open).
Hope this helps.

 

[venitacason]

Thank you!

@JBHansen thank you so much that was very helpful!

I appreciate it!

Venita