CPT® Code 33958

Extracorporeal membrane oxygenation (ECMO)/extracorporeal life support (ECLS) provided by physician; reposition peripheral (arterial and/or venous) cannula(e), percutaneous, 6 years and older (includes fluoroscopic guidance, when performed)

Extracorporeal membrane oxygenation (ECMO) and extracorporeal life support (ECLS) are terms that refer to advanced medical procedures designed to provide long-term support for patients with severe heart and lung dysfunction. These procedures involve the use of an artificial lung to oxygenate blood outside the body, allowing it to be circulated back into the bloodstream. The process is critical for patients who are unable to maintain adequate oxygenation or perfusion due to various medical conditions. The peripheral arterial and/or venous cannula(e) utilized in ECMO/ECLS are typically inserted into the vena cava, where desaturated blood is drawn from the inferior vena cava (IVC) into the ECMO/ECLS circuit. Once oxygenated, the blood is returned to the superior vena cava, entering the right atrium and subsequently directed towards the tricuspid valve. Maintaining optimal positioning of the cannula(e) is essential for effective ECMO/ECLS support, as any migration can lead to recirculation and suboptimal oxygenation. The procedure for repositioning these cannula(e) is performed percutaneously, which involves the removal of any dressings or sutures that secure the tubing to the skin. Under fluoroscopic guidance, the physician carefully manipulates the cannula(e) to ensure they are optimally placed, confirming the correct positioning before reconnecting the ECMO/ECLS circuit. This procedure is specifically indicated for patients aged 6 years and older, as denoted by CPT® Code 33958, while a different code, 33957, is applicable for younger patients, specifically newborns through 5 years of age.