CPT® Code 33954

Extracorporeal membrane oxygenation (ECMO)/extracorporeal life support (ECLS) provided by physician; insertion of peripheral (arterial and/or venous) cannula(e), open, 6 years and older

Extracorporeal membrane oxygenation (ECMO) and extracorporeal life support (ECLS) are terms that refer to advanced medical procedures designed to provide temporary support for patients with severe heart and lung dysfunction. These procedures are typically utilized for a duration ranging from three to ten days, during which they facilitate the oxygenation of blood outside the body. The process involves draining venous blood from a large central vein, which is then passed through an artificial lung for oxygenation before being returned to the bloodstream, either to the venous system or a major artery. The insertion of peripheral arterial and/or venous cannulae is performed using an open surgical technique, which entails making an incision in the skin over the targeted vessel, such as the femoral or jugular vein. This incision allows for the dissection of underlying tissues to access the vessel. A small opening is created in the vessel itself, through which a guidewire is introduced and positioned accurately, often confirmed via fluoroscopy. The vessel is then dilated progressively to accommodate the cannula or introducer unit, which is advanced over the guidewire. Once the correct placement is verified, the guidewire and introducer are removed, and the cannula is secured. The ECMO/ECLS circuit, which has been prepped and primed, is then connected to the cannula, initiating the life-support treatment. Following the procedure, the incisions are closed, and the tubing is secured to ensure stability. It is important to note that CPT® Code 33953 is designated for the insertion of open peripheral cannulae in patients from newborn to 5 years old, while CPT® Code 33954 applies to patients aged 6 years and older.