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
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