Ask Dr. Z

What is the proper code for the scenario below? The patient is a middle aged man with a witnessed cardiac arrest. He was in V-fib, taken to the cath lab, placed on AV ECMO, and underwent PCI. "A 19 French cannula was placed in the right common femoral artery and a 25 French cannula in the right femoral vein. An Impella was placed in the left common femoral artery over a 14 French sheath. I was asked by Dr. X to place a distal perfusion cannula. The micropuncture wire was advanced under fluoroscopy, and a 4 French sheath introducer was placed. The wire was exchanged for a J wire, and the 6 French antegrade perfusion cannula was placed under fluoro visualization. Of note, the SFA appeared to be calcified in fluoro, and an SFA stent was visualized. The wire and cannula were advanced without any complications. The perfusion cannula was flushed and secured to the right groin, then connected to the ECMO circuit, achieving antegrade perfusion of the right lower extremity." Would 33952 or 36140 be the best code, or does it bundle to the ECMO placement?