CPT code 33951 is used for the insertion of a peripheral cannula for ECMO/ECLS, a procedure supporting heart and lung function.
CPT code 33951 is used to describe the insertion of a peripheral cannula for extracorporeal membrane oxygenation (ECMO) or extracorporeal life support (ECLS). This procedure involves placing a cannula, which is a thin tube, into a peripheral blood vessel to facilitate the circulation of blood outside the body through an ECMO or ECLS machine. This is typically done to provide cardiac and respiratory support to patients whose heart and lungs are unable to function adequately on their own. The peripheral approach usually involves accessing vessels in the limbs, such as the femoral artery or vein.
For CPT code 33951, which involves the insertion of peripheral cannula for ECMO/ECLS, the following modifiers may be applicable:
1. Modifier 59 (Distinct Procedural Service): This modifier is used to indicate that a procedure or service was distinct or independent from other services performed on the same day. It may be necessary if multiple procedures are performed and need to be reported separately.
2. Modifier 62 (Two Surgeons): If two surgeons are required to perform the procedure due to its complexity, this modifier indicates that each surgeon performed a distinct part of the procedure.
3. Modifier 66 (Surgical Team): This modifier is applicable when a highly complex procedure requires the skills of a surgical team.
4. Modifier 76 (Repeat Procedure by Same Physician): If the procedure needs to be repeated by the same physician, this modifier is used to indicate the repeat service.
5. Modifier 77 (Repeat Procedure by Another Physician): This modifier is used when the procedure is repeated by a different physician.
6. Modifier 78 (Unplanned Return to the Operating/Procedure Room by the Same Physician Following Initial Procedure for a Related Procedure During the Postoperative Period): If the patient requires an unplanned return to the operating room for a related procedure, this modifier is applicable.
7. Modifier 79 (Unrelated Procedure or Service by the Same Physician During the Postoperative Period): This is used when an unrelated procedure is performed by the same physician during the postoperative period.
8. Modifier 80 (Assistant Surgeon): If an assistant surgeon is necessary for the procedure, this modifier is used to indicate their involvement.
9. Modifier 81 (Minimum Assistant Surgeon): This is used when a minimum assistant surgeon is required for the procedure.
10. Modifier 82 (Assistant Surgeon (when qualified resident surgeon not available)): This modifier is used when an assistant surgeon is required due to the unavailability of a qualified resident surgeon.
These modifiers help provide additional information about the circumstances under which the procedure was performed, ensuring accurate billing and reimbursement. It's important to review payer-specific guidelines as they may have unique requirements for modifier usage.
CPT code 33951 is subject to reimbursement considerations under Medicare, specifically through the Medicare Physician Fee Schedule (MPFS). The MPFS is a comprehensive listing of fees used by Medicare to reimburse physicians and other healthcare providers for services rendered. However, whether CPT code 33951 is reimbursed by Medicare can depend on several factors, including the specific policies of the Medicare Administrative Contractor (MAC) that processes claims in your region. MACs are responsible for interpreting national Medicare policies and may have additional local coverage determinations that affect reimbursement. Therefore, it is essential for healthcare providers to verify with their respective MAC to determine if CPT code 33951 is covered and reimbursed under Medicare in their specific jurisdiction.
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