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Prolonged extracorporeal circulation for cardiopulmonary insufficiency, as denoted by CPT® Code 33960, refers to a medical procedure commonly known as extracorporeal membrane oxygenation (ECMO). This advanced life-support technique employs a cardiopulmonary bypass circuit to temporarily take over the function of the heart and lungs in patients experiencing reversible cardiac and/or respiratory failure. ECMO is particularly beneficial for neonates, children, and adults whose conditions have not improved with standard medical therapies. During the procedure, a physician is responsible for closely monitoring the patient’s status and making necessary adjustments to the ECMO parameters. This is done to ensure optimal support for both cardiac and respiratory functions, which is assessed through blood gas analyses and other clinical observations. It is important to note that CPT® Code 33960 is specifically designated for billing the initial day of ECMO maintenance, while subsequent days of treatment are billed using CPT® Code 33961.
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Extracorporeal membrane oxygenation (ECMO) is indicated for patients experiencing severe cardiac and/or respiratory failure that is reversible and has not responded adequately to conventional medical therapies. The following conditions may warrant the use of ECMO:
The procedure for initiating ECMO involves several critical steps to ensure the safe and effective support of the patient’s cardiopulmonary function. The following outlines the procedural steps:
After the initiation of ECMO, the patient requires continuous monitoring and care. Post-procedure considerations include regular assessments of hemodynamic stability, oxygenation levels, and potential complications such as bleeding or infection at the cannulation sites. The healthcare team must also evaluate the patient's response to ECMO therapy and determine the appropriate duration of support. Once the underlying condition improves, the ECMO support can be gradually weaned, and the cannulas will be removed following established protocols to ensure patient safety and minimize risks.
| Short Descr | EXTERNAL CIRCULATION ASSIST | Medium Descr | PROLONGED EXTRACORPOREAL CIRCULATION INIT DAY | Long Descr | Prolonged extracorporeal circulation for cardiopulmonary insufficiency; initial day | Status Code | Active Code | Global Days | 000 - Endoscopic or Minor Procedure | PC/TC Indicator (26, TC) | 0 - Physician Service Code | Multiple Procedures (51) | 0 - No payment adjustment rules for multiple procedures apply. | Bilateral Surgery (50) | 0 - 150% payment adjustment for bilateral procedures does NOT apply. | Physician Supervisions | 9 - Concept does not apply. | Assistant Surgeon (80, 82) | 2 - Payment restriction for assistants at surgery does not apply to this procedure... | Co-Surgeons (62) | 1 - Co-surgeons could be paid, though supporting documentation is required... | Team Surgery (66) | 0 - Team surgeons not permitted for this procedure. | Diagnostic Imaging Family | 99 - Concept Does Not Apply | APC Status Indicator | Inpatient Procedures, not paid under OPPS | Type of Service (TOS) | 2 - Surgery | Berenson-Eggers TOS (BETOS) | P2F - Major procedure, cardiovascular-Other | MUE | Not applicable/unspecified. | CCS Clinical Classification | 50 - Extracorporeal circulation auxiliary to open heart procedures |
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