Wiki Reinstitution of cardiopulmonary bypass

[Cothran]

Please help me with coding:

1. CABG x 5 with left LIMA to the left anterior descending LAD, saphenous vein graft to the first diagonal, obtuse marginal, posterior descending artery and posterolateral artery.

2. Emergency external and internal cardiopulmonary resuscitation followed by reinstitution of cardiopulmonary bypass with additional grafting to the distal left anterior descending artery and successful weaning from cardiopulmonary bypass with low dose Levophed and atrial pacing.

Question: Can I bill for the reinstituion of the cardiopulmonary bypass and if so, what code?

 

[dimmitta]

I would not bill for the reinstitution of cardiopulmonary bypass in this case since it was reinstituted for additional interventional procedure and then reweaned successfully.

If all interventional procedures had been completed, and the patient was weaned off CPB but due to hemodynamic instability before leaving the OR needed to be put back on, then I would code as an ECMO with CPT 36822.

HTH,
A.D.