Results 1 to 8 of 8

Ecmo - I have never billed for this

  1. #1
    Default Ecmo - I have never billed for this
    Clearnace Sale
    I have never billed for this before, but the dr did the cannula (36822) and the pt was on the machine for 2 days (33960,33961). I coded the daily codes but did not code the cannula because it says separate procedure. Is this correct? Is there a requirement of the dr being at the bedside for a certain amt of time or any special documentation requirements for the daily codes? Does he have to say "pt still on Ecmo" or anything llike that? Can the ECMO codes be billed with critical care codes?
    Thanks a lot!!!

  2. #2
    Milwaukee WI
    Default Separate procedure
    ECMO is a separate procedure if it is NOT done as part of other heart/lung surgery.

    In our setting (Pediatric hospital) the surgeon inserts the ECMO cannula; the intensivist is the one who is managing the ECMO. So one doctor bills the 36822; another doctor bills 33960/33961. Only one physician can bill the 33960/33961 code per day, so be sure the intensivist is not doing so. (The code is for 24 hours of care.)

    Yes, you can bill critical care AND ECMO management on the same date of service (assuming your documentation support this). For critical care, the MD must be at bedside for a minimum of 30 minutes.

    Documentation must reference ECMO each date, preferably with settings or some statement as to patient's repsonse to this.

    Hope this helps.
    F Tessa Bartels, CPC-E/M

  3. #3
    Default thanks!
    That was a HUGE help! This is for an adult pt and the intensivist did the ECMO as well as managing it afterwards each day. He is new and we just started doing these.

  4. #4
    Milwaukee WI
    Default Don't forget modifier
    Don't forget your -25 modifier on critical care code if you are also billing ECMO management daily.

    HOWEVER ... inserting the ECMO cannula - CPT 36822 - has a 90 day global period! So your ciritcal care codes would probably be considered global.

    Can you post sanitized op notes / progress notes?

    Feel free to call me - I'm in Wisconsin -

    F Tessa Bartels CPC-E/M

  5. #5
    Default thank you SO MUCH
    I wrote down your number. We have intensivists who bill daily care post op in the SICU for things such as repiratory failure. This guy came here from Germany and this ECMO thing is totally new for our CT dept. Plus he is not used to our endless rules for documentation! So far he has been doing this at the bedside in the ICU. Thanks for all your help and have a GREAT 4th of July!!!

  6. #6
    Milwaukee WI
    Default Sounds like you were correct
    Without seeing the notes I can only guess, but it sounds as if you were correct in the way you billed (33960 first day / 33961 each subsequent day on ECMO).

    Now, IF he had documentation to support critical care (with 30 minutes or more at bedside each day) then you can also bill that w/ -25 modifier on the critical care.

    Feel free to call or email me at

    F Tessa Bartels, CPC-E/M

  7. Default
    Do you bill the first day the same day that the cannula is inserted or after the first 24 hours is up?

    Is this the correct way a patient should be billed on ECMO for 36 hours and passed away on 7/8/08?
    36822 done on 7/7/08
    33960 billed 7/7/08
    33961 billed on 7/8/08 with a 52 modifier


  8. Default echo billing with echmo
    which TEE/echo codes do you bill with echmo 93318 or 93308, 93321, 93325

Similar Threads

  1. Ecmo - Looking for CPT/ASA code
    By OEHMLER5 in forum Anesthesia
    Replies: 1
    Last Post: 07-26-2015, 11:33 AM
  2. Ecmo
    By Gainingknowledgedaily in forum Cardiology
    Replies: 0
    Last Post: 04-16-2013, 03:33 PM
  3. Ecmo
    By vergor in forum Cardiovascular Thoracic
    Replies: 0
    Last Post: 03-20-2013, 10:37 AM
  4. ECMO Removal w/reinsert of ECMO w/Dacron conduit
    By in forum Cardiovascular Thoracic
    Replies: 0
    Last Post: 07-06-2011, 03:32 PM
  5. Ecmo
    By hburns in forum Medical Coding General Discussion
    Replies: 2
    Last Post: 12-03-2010, 12:25 PM

Posting Permissions

  • You may not post new threads
  • You may not post replies
  • You may not post attachments
  • You may not edit your posts
Enjoying Our Forums?

AAPC forums are a benefit of membership. Joining AAPC grants you unlimited access, allowing you to post questions and participate with our community of over 150,000 professionals.

Join Now Continue Reading Without Full Access

Already a Member?


Close Message

In addition to full participation on AAPC forums, as a member you will be able to:

  • Access to the largest healthcare job database in the world.
  • Join over 150,000 members of the healthcare network in the world.
  • Be a part of an industry leading organization that drives the business side of healthcare.
  • Save anywhere from 10%-50% with exclusive member discounts on courses, books, study materials, and conferences.
  • Access to discounts at hundreds of restaurants, travel destinations, retail stores, and service providers. AAPC members also have opportunities to save on heath, life, and liability insurance.
  • Become a member of a local chapter and attend regular meetings.