CPT code 33985 is used for the removal of a central cannula in ECMO/ECLS procedures, essential for accurate procedure documentation.
CPT code 33985 is used to describe the procedure of removing a central cannula that was previously inserted for ECMO (Extracorporeal Membrane Oxygenation) or ECLS (Extracorporeal Life Support). This code is specifically utilized when the central cannula, which is a tube inserted into a large central vein or artery, is removed after the completion of ECMO/ECLS treatment. ECMO/ECLS is a life-support technique used for patients with severe and life-threatening illness that stops their heart or lungs from working properly. The removal of the cannula is a critical step in the process, indicating that the patient no longer requires this intensive support.
For CPT code 33985, which pertains to the removal of a central cannula for ECMO/ECLS, the following modifiers may be applicable:
1. Modifier 22 - Increased Procedural Services: This modifier is used when the work required to perform the procedure is substantially greater than typically required. This could apply if there are complications or additional factors that make the removal more complex.
2. Modifier 52 - Reduced Services: This modifier is used when a service or procedure is partially reduced or eliminated at the physician's discretion. It might be applicable if the removal process was less extensive than usual.
3. 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 the removal is performed in conjunction with other procedures that are not typically performed together.
4. Modifier 76 - Repeat Procedure or Service by Same Physician or Other Qualified Health Care Professional: This modifier is used when a procedure or service is repeated by the same provider. It could be relevant if the removal needs to be performed more than once.
5. Modifier 77 - Repeat Procedure by Another Physician or Other Qualified Health Care Professional: This modifier is used when a procedure is repeated by a different provider. It might be applicable if the removal is performed again by another healthcare professional.
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: This modifier is used when a patient returns to the operating room for a related procedure during the postoperative period. It could apply if complications arise necessitating a return to the operating room.
7. 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 might be used if the removal is unrelated to the initial surgery.
These modifiers help provide additional information about the circumstances of the procedure, ensuring accurate billing and reimbursement. Always consult the latest coding guidelines and payer-specific policies to confirm the appropriate use of modifiers.
CPT code 33985, which involves a specific medical procedure, is subject to reimbursement considerations under Medicare. To determine if this code is reimbursed by Medicare, healthcare providers should refer to the Medicare Physician Fee Schedule (MPFS). The MPFS provides a comprehensive list of services and their corresponding reimbursement rates, which are updated annually.
Additionally, it's important to consult with the local Medicare Administrative Contractor (MAC), as they are responsible for processing Medicare claims and can provide specific guidance on coverage and reimbursement for CPT code 33985. MACs may have local coverage determinations (LCDs) that affect whether a particular service is reimbursed in a specific region. Therefore, checking both the MPFS and consulting with the relevant MAC will provide the most accurate information regarding the reimbursement status of CPT code 33985 under Medicare.
Discover the power of MD Clarity's RevFind software to ensure you're receiving the full reimbursement you deserve. With the ability to read your contracts and detect underpayments down to the CPT code level, including specific codes like 33985, RevFind provides unparalleled accuracy and insight. Schedule a demo today to see how RevFind can help you identify discrepancies by individual payer and 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
