I have never coded these daily management codes for the ECMO, so can they be billed with the subsequent hospital visits. If so is there any reference material pertaining to this? Any help would be greatly appreciated!
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Pediatric ECMO Coding for a circuit Change
Hello, my clinician and I are disagreeing on what CPT code should be used for an ECMO Circuit Change. I am leaning towards CPT 33949-Extracorporeal membrane oxygenation (ECMO/extracorporeal life support (ECLS) provided by physician; daily management, each day, veno-arterial.
Here is the scrubbed documentation; PROCEDURE: This procedure was done at the bedside in the NICU. We prepped and draped the cannula sites in the usual fashion. We prepared the venous and arterial lines from the new circuit and these were held in place in a sterile fashion. We then made incisions in the cannula at the connector sites. We then clamped the venous and arterial cannulae on the patient’s side and on the circuit side, therefore coming off ECMO and at that very moment, the patient was put on rescue settings on the conventional ventilator. We then disconnected the old ECMO circuit by detaching the circuit tubing from the venous and arterial cannnula and these were moved away. We then brought the new venous and arterial lines and attached them to the cannulas, ensuring that we did not introduce any air into the circuit. We then went back on ECMO with good flows and achieved an immediate improvement in the pressure gradient across the membrane oxygenator. I was present for the duration of the procedure. The circuit change took approximately 90 seconds.
Here is the scrubbed documentation; PROCEDURE: This procedure was done at the bedside in the NICU. We prepped and draped the cannula sites in the usual fashion. We prepared the venous and arterial lines from the new circuit and these were held in place in a sterile fashion. We then made incisions in the cannula at the connector sites. We then clamped the venous and arterial cannulae on the patient’s side and on the circuit side, therefore coming off ECMO and at that very moment, the patient was put on rescue settings on the conventional ventilator. We then disconnected the old ECMO circuit by detaching the circuit tubing from the venous and arterial cannnula and these were moved away. We then brought the new venous and arterial lines and attached them to the cannulas, ensuring that we did not introduce any air into the circuit. We then went back on ECMO with good flows and achieved an immediate improvement in the pressure gradient across the membrane oxygenator. I was present for the duration of the procedure. The circuit change took approximately 90 seconds.
Any direction anyone can provide will be greatly appreciated.
C. Waddock, CPC
ANESTHESIA coding for cardiac procedure when patient on ECMO
I have an 8 day old patient that had a DAMUS/KAYE/STANZEL procedure. The patient was on bypass and ECMO – I coded CPT code 33606 with the ASA code of 00561. I have coded for the A line 36620, the C line 36555 and the ultrasound 76937 (all are documented) but is there an additional code I should use for the ECMO?
(The patient is already on ECMO)
I would greatly appreciate any help.
thanks,
(The patient is already on ECMO)
I would greatly appreciate any help.
thanks,