ECMO Clinical Service Structure and Scope of Practice 2. Equipment referred to in this Protocol This protocol is written for the use with two Maquet ECMO Systems The PLS 2050 circuit and Rotaflow® Blood Pump HLS Advanced 7.0 circuit and Cardiohelp® At The Alfred, ECMO always involves a centrifugal pump to drive circuit flow. 3. ECMO Definitions ECMO or Extra Corporeal Membrane Oxygenation is a form of extracorporeal life support where an external artificial circuit carries venous blood from the patient to a gas exchange device (oxygenator)
http://www.alfredicu.org.au/assets/Documents/ICU-Guidelines/ECMO/ECMOGuideline.pdf
Learn about coding for ECMO/ECLS in Critical Care. Extracorporeal membrane oxygenation (ECMO) or extracorporeal life support (ECLS) is a cardiopulmonary bypass technique.
http://www.sccm.org/Communications/Critical-Connections/Archives/Pages/Coding-for-ECMOECLS-in-Critical-Care.aspx
Extracorporeal membrane oxygenation. [edit on Wikidata] Extracorporeal membrane oxygenation (ECMO), also known as extracorporeal life support (ECLS), is an extracorporeal technique of providing prolonged cardiac and respiratory support to persons whose heart and lungs are unable to provide an adequate amount of gas exchange to sustain life.
https://en.wikipedia.org/wiki/Extracorporeal_membrane_oxygenation
Extracorporeal Membrane Oxygenation (ECMO) Prompt Doc No: <#doc_num> v<#ver_num> Approval Date: Nov 2012 Review & Update by: Nov 2015. Page 1 of 64. The hard copy of this document may be out of date. To ensure you are reading the current version, check the policy and guideline site on. the Alfred Health Intranet.
http://www.alfredicu.org.au/assets/Documents/ICU-Guidelines/ECMO/ECMOGuideline.pdf
ECMO circuit blood flow is optimised to provide adequate patient support in the absence of native lung or heart function. Partial Extra Corporeal Life Support incorporates a membrane oxygenator, but cannot support
http://www.alfredicu.org.au/assets/Documents/ICU-Guidelines/ECMO/ECMOGuideline.pdf
Subsequent Management and Repositioning. CPT codes 33948 and 33949 are reported for daily management of the ECMO/ECLS circuit and monitoring parameters, which requires physician oversight to ensure that specific features of the interaction of the circuit with the patient are met.
http://www.sccm.org/Communications/Critical-Connections/Archives/Pages/Coding-for-ECMOECLS-in-Critical-Care.aspx
Pre pump access ports (PLS only): All ECMO circuits primed at The Alfred have no access ports. on the negative pressure (access) side of the circuit to reduce the incidence of air entrainment. PLS circuits do come with two ports on the negative pressure (access) side of circuit when. removed from box.
http://www.alfredicu.org.au/assets/Documents/ICU-Guidelines/ECMO/ECMOGuideline.pdf
CPT codes 33987–33989 are not bundled with the other ECMO procedures under NCCI and can be reported as additional procedures with ECMO insertion, repositioning or decannulation. Note that a code with a + sign (e.g., 33987) is an add-on code and is reported secondary to a primary procedure. Coding Guidance. Critical care services as well as other daily management evaluation and management services are not included in the ECMO/ECLS procedures 33946, 33947, 33948, and 33949.
http://www.sccm.org/Communications/Critical-Connections/Archives/Pages/Coding-for-ECMOECLS-in-Critical-Care.aspx
The following CPT codes are reported for ECMO/ECLS: Initiation. CPT codes 33946–33947 include: • Determining the necessary ECMO/ECLS device component • Blood flow • Gas exchange • Parameters to manage the circuit. CPT codes 33951–33956 are reported for insertion or replacement of the ECMO/ECLS cannula in the same vessel. Codes are selected based on the patient’s age and the approach:
http://www.sccm.org/Communications/Critical-Connections/Archives/Pages/Coding-for-ECMOECLS-in-Critical-Care.aspx
Return Cannulae: deliver blood back to the patient from the ECMO circuit and only ever expel blood at the cannula tip (single stage). c. Distal Perfusion Cannula: Deliver blood antegradely into the femoral artery distal to the ECMO
http://www.alfredicu.org.au/assets/Documents/ICU-Guidelines/ECMO/ECMOGuideline.pdf
code for changing of ecmo circuit
Current Procedural Terminology codes 33951 to 33956 are used for insertion or replacement of the extracorporeal membrane oxygenation circuit. CPT codes 33951–33956 are reported for insertion or replacement of the ECMO/ECLS cannula in the same vessel.