Wiki ECMO decannulation

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jewlz0879

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I have a physician that tries to use 33977 for removal of ECMO but I just don't think that is the correct way to bill it. I know there are a couple different directions: 1. per CPT Assistant Feb 97 we were instructed to use 37799; 2. however, STS has suggested use of 35226 as essentially we are repairing the b.v. after cannula removal.

What are other CT coders thoughts on this? I feel that ECMO is a little different from VAD and so we are misrepresenting what is actually done.

Thoughts?

THANKS!
 
I bill this all the time and use unlisted code of 37799. We have it set up with a suffix for pricing. I can't say we ever get paid for it, but..... That is how we bill it.
 
How would you bill if the physician perfromed decannulation of the patient off of ECMO, performed direct surgical repair of the femoral artery from a previous percutaneous cannulation site, and recannulation of the same femoral artery just more proximal for continuous ECMO?? He also performed direct surgical repair of the ipsilateral common femoral for surgical hemostasis.
 
Julie,

I bill for the repair of the blood vessel (ie: 35226), in fact, I am coding one right now - ha! Like you, I got this info from the STS.

I agree that billing 33977 would be over-coding. Removal of an actual ventricular assist device often requires repairing holes in the heart, that is not the case with an ECMO.

Lisi, CPC
eharkler@nmh.org
 
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