Wiki Pediatric ECMO Coding for a circuit Change

Waddock

New
Messages
2
Location
West Haven, CT
Best answers
0
Hello, my clinician and I are disagreeing on what CPT code should be used for an ECMO Circuit Change. I am leaning towards CPT 33949-Extracorporeal membrane oxygenation (ECMO/extracorporeal life support (ECLS) provided by physician; daily management, each day, veno-arterial.
Here is the scrubbed documentation; PROCEDURE: This procedure was done at the bedside in the NICU. We prepped and draped the cannula sites in the usual fashion. We prepared the venous and arterial lines from the new circuit and these were held in place in a sterile fashion. We then made incisions in the cannula at the connector sites. We then clamped the venous and arterial cannulae on the patient's side and on the circuit side, therefore coming off ECMO and at that very moment, the patient was put on rescue settings on the conventional ventilator. We then disconnected the old ECMO circuit by detaching the circuit tubing from the venous and arterial cannnula and these were moved away. We then brought the new venous and arterial lines and attached them to the cannulas, ensuring that we did not introduce any air into the circuit. We then went back on ECMO with good flows and achieved an immediate improvement in the pressure gradient across the membrane oxygenator. I was present for the duration of the procedure. The circuit change took approximately 90 seconds.

Any direction anyone can provide will be greatly appreciated.
C. Waddock, CPC
 
Hi,

Whether CPT 33947 -

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

because given in the notes - "We prepared the venous and arterial lines from the new circuit";

Regards,
Lavanya Mohan
 
Late answer on ECMO

Hi,

I saw your question and asked a few experts before answering. The physician is not changing the ECMO cannulae, just the tubing that connects the cannulae to the machine. This is included in daily ECMO management and/or critical care services (depending on which role the physician held).

I hope that this is in time to help.
Cindy

Hello, my clinician and I are disagreeing on what CPT code should be used for an ECMO Circuit Change. I am leaning towards CPT 33949-Extracorporeal membrane oxygenation (ECMO/extracorporeal life support (ECLS) provided by physician; daily management, each day, veno-arterial.
Here is the scrubbed documentation; PROCEDURE: This procedure was done at the bedside in the NICU. We prepped and draped the cannula sites in the usual fashion. We prepared the venous and arterial lines from the new circuit and these were held in place in a sterile fashion. We then made incisions in the cannula at the connector sites. We then clamped the venous and arterial cannulae on the patient's side and on the circuit side, therefore coming off ECMO and at that very moment, the patient was put on rescue settings on the conventional ventilator. We then disconnected the old ECMO circuit by detaching the circuit tubing from the venous and arterial cannnula and these were moved away. We then brought the new venous and arterial lines and attached them to the cannulas, ensuring that we did not introduce any air into the circuit. We then went back on ECMO with good flows and achieved an immediate improvement in the pressure gradient across the membrane oxygenator. I was present for the duration of the procedure. The circuit change took approximately 90 seconds.

Any direction anyone can provide will be greatly appreciated.
C. Waddock, CPC
 
Late answer on ECMO

Hi,

I saw your question and asked a few experts before answering. The physician is not changing the ECMO cannulae, just the tubing that connects the cannulae to the machine. This is included in daily ECMO management and/or critical care services (depending on which role the physician held).

I hope that this is in time to help.
Cindy
Hi Cynthia,
Do you have a reference to support this? Who were the experts you were referring to? I would like to have on hand for future reference.

Thanks so much!
 
Top