Summary & Overview
CPT 33986: Central Cannula Removal After Open Sternotomy/Thoracotomy, Child 6+
CPT code 33986 denotes surgical removal of a central cannula for extracorporeal circulation via an open sternotomy or thoracotomy in children age six and older. This code captures a discrete, operative step in the management of pediatric patients who have undergone procedures requiring cardiopulmonary bypass or extracorporeal support. Nationally, accurate use of this code is important for procedure tracking, quality measurement, and proper facility and professional billing for complex pediatric cardiac surgical care.
Key payers addressed include Aetna, Blue Cross Blue Shield, Cigna Health, UnitedHealthcare, and Medicare. The publication provides readers with clinical context for when the procedure is reported, outlines service and site-of-care expectations, and flags common billing modifiers and payment considerations for institutional and professional claims. It also summarizes benchmark metrics, code mapping to related surgical services, and recent policy or payer updates where available. Readers will gain a concise reference for correct coding application, common payer coverage patterns, and areas where documentation typically supports code selection.
Data not available in the input is noted where specifics are absent.
Billing Code Overview
CPT code 33986 describes the removal of a central cannula for extracorporeal circulation performed through an open sternotomy or thoracotomy approach in a child six years and older. This procedure involves surgical removal of the cannula used for cardiopulmonary bypass or extracorporeal support following procedures that required extracorporeal circulation.
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Service type: Surgical procedure, circulatory support device removal
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Typical site of service: Inpatient operating room or surgical suite following sternotomy or thoracotomy
Clinical & Coding Specifications
Clinical Context
A typical patient is a child aged six years or older recovering from cardiac surgery that required cardiopulmonary bypass via a central cannula placed through an open sternotomy or thoracotomy. Postoperative indications for removal include successful separation from extracorporeal circulation, stable hemodynamics, no air entrainment, and adequate coagulation status. The clinical workflow includes assessment in the operating room or cardiac intensive care unit by the cardiothoracic surgical team; confirmation of hemostasis and ventilatory/oxygenation stability; preparation of sterile field and wound exposure through the existing sternotomy or thoracotomy incision; controlled removal of the central cannula with immediate hemostatic maneuvers; placement of chest drains if indicated; closure or management of the chest incision per surgeon preference; and postoperative monitoring for bleeding, cardiac tamponade, vascular injury, or infection. Documentation includes indication for removal, patient age (>6 years), approach (open sternotomy or thoracotomy), anesthesia type, personnel involved, any intraoperative complications, and disposition to recovery or ICU care.
Coding Specifications
| Modifier | Description | When to Use |
|---|---|---|
00 | No modifier (default) | Use when no modifier applies and standard reporting is appropriate |
11 |