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Code deleted, see 33948, 33949

Official Description

Prolonged extracorporeal circulation for cardiopulmonary insufficiency; each subsequent day

© Copyright 2025 American Medical Association. All rights reserved.

Common Language Description

Prolonged extracorporeal circulation for cardiopulmonary insufficiency, represented by CPT® Code 33961, refers to the use of extracorporeal membrane oxygenation (ECMO) as a therapeutic intervention for patients experiencing reversible cardiac and/or respiratory failure. ECMO is a sophisticated medical procedure that employs a cardiopulmonary bypass circuit to temporarily take over the function of the heart and lungs, thereby providing critical support to patients whose conditions have not improved with standard medical therapies. This procedure is applicable to a diverse patient population, including neonates, children, and adults, who are facing severe cardiac and/or respiratory challenges. During the ECMO process, the physician plays a vital role in continuously monitoring the patient's condition and making necessary adjustments to the ECMO settings. This is done to ensure optimal support for both cardiac and respiratory functions, which is assessed through various tests, including blood gas analyses and clinical observations. It is important to note that CPT® Code 33961 is specifically designated for billing purposes for each subsequent day of ECMO maintenance following the initial day, which is coded using CPT® Code 33960.

© Copyright 2025 Coding Ahead. All rights reserved.

1. Indications

The indications for prolonged extracorporeal circulation for cardiopulmonary insufficiency, as represented by CPT® Code 33961, include the following conditions where ECMO may be utilized:

  • Reversible Cardiac Failure - Patients experiencing temporary cardiac dysfunction that can potentially improve with medical intervention.
  • Reversible Respiratory Failure - Patients with acute respiratory distress or failure that is not responding to conventional treatments.
  • Failure to Respond to Medical Therapy - Situations where patients have not shown improvement despite receiving appropriate medical management for their cardiac or respiratory conditions.

2. Procedure

The procedure for prolonged extracorporeal circulation for cardiopulmonary insufficiency involves several critical steps, which are detailed as follows:

  • Initial Setup of ECMO Circuit - The procedure begins with the establishment of the ECMO circuit, which includes the insertion of cannulas into the patient's blood vessels. This setup allows for the diversion of blood from the body to the ECMO machine, where it is oxygenated and then returned to the patient.
  • Monitoring and Adjustment - Once the ECMO circuit is operational, the physician continuously monitors the patient's vital signs, blood gases, and other relevant parameters. Adjustments to the ECMO settings are made as necessary to ensure that the patient receives optimal support for both cardiac and respiratory functions.
  • Daily Assessment - Each subsequent day of ECMO maintenance requires a thorough assessment of the patient's condition. The physician evaluates the effectiveness of the ECMO therapy and determines whether to continue, modify, or discontinue the treatment based on the patient's response and clinical status.

3. Post-Procedure

Post-procedure care following prolonged extracorporeal circulation for cardiopulmonary insufficiency involves careful monitoring of the patient as they transition off ECMO support. This includes assessing the patient's cardiac and respiratory function to determine readiness for weaning from ECMO. Additionally, healthcare providers must watch for potential complications associated with ECMO, such as bleeding, infection, or thrombosis. The recovery process may vary depending on the underlying condition that necessitated ECMO, and ongoing support and rehabilitation may be required to ensure optimal recovery.

Short Descr EXTERNAL CIRCULATION ASSIST
Medium Descr PROLONGED EXTRACORPOREAL CIRCULATION EA ADDL DAY
Long Descr Prolonged extracorporeal circulation for cardiopulmonary insufficiency; each subsequent day
Status Code Active Code
Global Days XXX - Global Concept Does Not Apply
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) 1 - Statutory payment restriction for assistants at surgery applies 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
Date
Action
Notes
2015-01-01 Deleted Code deleted, see 33948, 33949
2012-01-01 Changed Description Changed
1994-01-01 Added First appearance in code book in 1994.
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