CPT® Code 33962

Extracorporeal membrane oxygenation (ECMO)/extracorporeal life support (ECLS) provided by physician; reposition peripheral (arterial and/or venous) cannula(e), open, 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 a sophisticated system that circulates blood outside the body through an artificial lung, where it is oxygenated before being returned to the bloodstream. This process is critical for patients whose heart and lungs are unable to function adequately on their own, allowing for temporary support while the underlying condition is treated or while the organs recover. The peripheral arterial and/or venous cannula(e) used in ECMO/ECLS are typically inserted into the vena cava, facilitating the flow of desaturated blood from the inferior vena cava (IVC) to the ECMO/ECLS circuit. The oxygenated blood is then returned to the superior vena cava, directing flow towards the right atrium and subsequently the tricuspid valve. Proper positioning of the cannula(e) is essential for optimal support, as any migration can lead to inadequate circulation and potential complications. The procedure for repositioning these cannula(e) involves an open technique, which includes the removal of dressings and sutures, accessing the vessel through an incision, and utilizing fluoroscopic guidance to ensure accurate placement. This meticulous process is crucial for maintaining effective ECMO/ECLS support in patients aged 6 years and older.