CPT code 33957 is used for the procedure involving the repositioning of peripheral cannula during ECMO/ECLS therapy.
CPT code 33957 is used to describe the repositioning of peripheral cannulae for extracorporeal membrane oxygenation (ECMO) or extracorporeal life support (ECLS). This procedure involves adjusting the placement of cannulae, which are tubes inserted into blood vessels, to ensure optimal blood flow and support for patients undergoing ECMO/ECLS treatment. This code is typically used by healthcare providers to document and bill for the technical and clinical expertise required to reposition these cannulae, which are critical components in the management of patients with severe cardiac or respiratory failure.
For CPT code 33957, which pertains to ECMO/ECLS (Extracorporeal Membrane Oxygenation/Extracorporeal Life Support) repositioning of peripheral cannula, 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 is applicable when the ECMO/ECLS cannula repositioning is performed in conjunction with other procedures that are not typically reported together.
2. Modifier 76 (Repeat Procedure or Service by Same Physician or Other Qualified Health Care Professional): This modifier is used when the same procedure is repeated by the same provider. It may be applicable if the repositioning of the cannula needs to be performed more than once on the same day.
3. Modifier 77 (Repeat Procedure by Another Physician or Other Qualified Health Care Professional): This modifier is used when the same procedure is repeated by a different provider. It may be relevant if the cannula repositioning is performed again by another healthcare professional.
4. Modifier 78 (Unplanned Return to the Operating/Procedure Room by the Same Physician Following Initial Procedure for a Related Procedure During the Postoperative Period): This modifier is used when a patient requires an unplanned return to the operating room for a related procedure during the postoperative period. It could be applicable if the repositioning is necessary due to complications or issues arising from the initial procedure.
5. Modifier 79 (Unrelated Procedure or Service by the Same Physician During the Postoperative Period): This modifier is used when a procedure is performed during the postoperative period of another procedure, but is unrelated to the original procedure. It may be used if the repositioning is unrelated to the initial ECMO/ECLS procedure.
6. Modifier 22 (Increased Procedural Services): This modifier is used when the work required to provide a service is substantially greater than typically required. It may be applicable if the repositioning involves significant additional effort or complexity.
These modifiers help provide additional context and specificity to the billing and documentation of the procedure, ensuring accurate reimbursement and compliance with coding guidelines. Always consult the latest coding manuals and payer-specific guidelines to confirm the appropriate use of modifiers.
CPT code 33957 is subject to reimbursement considerations under Medicare, but whether it is reimbursed depends on several factors, including its inclusion in the Medicare Physician Fee Schedule (MPFS) and the specific guidelines set by the Medicare Administrative Contractor (MAC) in your region.
The MPFS provides a list of services and their associated reimbursement rates, but not all CPT codes are covered or reimbursed at the same rate across all regions.
Each MAC has the authority to interpret national Medicare policies and make determinations about coverage and reimbursement for specific services, including CPT code 33957.
Therefore, it is crucial for healthcare providers to consult the MPFS and their local MAC to determine the reimbursement status and any specific billing requirements for this code.
Discover the power of MD Clarity's RevFind software to ensure you're receiving the full reimbursement you deserve. With RevFind, you can effortlessly read your contracts and detect underpayments down to the CPT code level, including specific codes like 33957, and by individual payer. Don't let underpayments slip through the cracks—schedule a demo today to see how RevFind can optimize your revenue cycle management.
Get paid in full by bringing clarity to your revenue cycle
Subscribe to the
Healthcare Clarified newsletter
Get the latest insights on RCM and healthcare policy in your inbox
