CPT® Code 33964

Extracorporeal membrane oxygenation (ECMO)/extracorporeal life support (ECLS) provided by physician; reposition central cannula(e) by sternotomy or thoracotomy, 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 experiencing severe heart and lung failure. These procedures involve the use of a sophisticated system that circulates blood outside the body through an artificial lung, which oxygenates the blood and removes carbon dioxide before returning it to the patient's bloodstream. The process is critical for patients who cannot maintain adequate oxygenation or perfusion due to various medical conditions. The repositioning of central cannula(e) is a specific procedure performed under this umbrella of support, particularly when the initial placement of the cannula(e) requires adjustment to ensure optimal function. This repositioning is typically necessary when the cannula(e) have been placed in the right atrial appendage and the aortic arch or ascending aorta, or in cases of primary left heart failure where the left atrium has been cannulated to relieve pressure. The procedure is performed through a transthoracic approach, which may involve either a sternotomy (opening the chest through the sternum) or a thoracotomy (opening the chest through the ribs). Fluoroscopic guidance may be utilized during the procedure to ensure accurate placement of the cannula(e). This code, CPT® 33964, specifically applies to patients aged 6 years and older, distinguishing it from code 33963, which is used for younger patients (newborn through 5 years of age).