CPT® Code 33956

Extracorporeal membrane oxygenation (ECMO)/extracorporeal life support (ECLS) provided by physician; insertion of central cannula(e) by sternotomy or thoracotomy, 6 years and older

Extracorporeal membrane oxygenation (ECMO) and extracorporeal life support (ECLS) are terms that refer to a critical medical procedure used to provide long-term support for patients experiencing severe heart and lung failure. This procedure typically lasts from three to ten days and involves the circulation of blood outside the body through an artificial lung, which oxygenates the blood before it is returned to the patient's bloodstream. The insertion of central cannula(e) is a vital step in this process, particularly when performed via a transthoracic approach, which includes sternotomy or thoracotomy. This surgical intervention is most commonly executed during cardiac surgery, especially in cases where a patient is unable to transition off cardiopulmonary bypass. The surgical technique involves making an incision in the chest, either by separating the ribs or through a vertical cut along the sternum, to gain access to the heart. Once inside the chest cavity, the surgeon cannulates specific areas such as the right atrial appendage and the aortic arch or ascending aorta. In instances of primary left heart failure, the left atrium may be cannulated to facilitate left heart decompression. Following the cannulation, the tubing is connected to the ECMO/ECLS circuit, and the chest is subsequently closed with the tubing secured in place. It is important to note that CPT® Code 33955 is designated for the insertion of central cannula(e) in patients from newborn to 5 years old, while CPT® Code 33956 is specifically for patients aged 6 years and older.