# CTA Chest for Pulmonary Embolism



## markowitzm@mmri-ny.com (Jan 17, 2012)

When coding CTA does there have to be 3D reconstruction mentioned in the report?
I am now finding out that when Radiologist perform CTA chest they are not performing 3D reconstructions, however, they are performing post processing Coronal, Sagital and Axial, and paddlewheel reconstruction.  

Is this sufficent to code CTA or do they have to mention 3D reconstructions?

It states in the CPT book postprocessing it does not state 3D reconstructions have to be done.  

Does anyone have back up on CPT definition of post processing?

Thank you for the help.  Marcia


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## jmcpolin (Jan 17, 2012)

As noted in the Fall 2008 issue of Clinical Examples in Radiology, Computed Tomography Angiography is a distinct type of service that includes postprocessing for angiographic reconstructions.  In order to report “angiographic reconstructions” the physician needs to use different techniques which can all broadly be classified as 3D techniques. These include maximum intensity pixel (MIP) reconstruction, volume-rendered images, or other 3D techniques. If a referring physician orders a CT study for a vascular indication and the radiologist feels a CTA study is clinically indicated, appropriate documentation of the medical necessity for the CTA is strongly recommended.


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## donnajrichmond (Jan 17, 2012)

coleym said:


> When coding CTA does there have to be 3D reconstruction mentioned in the report?
> I am now finding out that when Radiologist perform CTA chest they are not performing 3D reconstructions, however, they are performing post processing Coronal, Sagital and Axial, and paddlewheel reconstruction.
> 
> Is this sufficent to code CTA or do they have to mention 3D reconstructions?
> ...



In addition to the Clinical Examples Q & A, there is also CPT Assistant, June 2009 (which has a Q & A specific to CT/CTA for pulmonary embolism), and ACR Radiology Coding Source, May/June 2009, which expands on the Clinical Examples Q & A.  (Coding Source is free online at http://www.acr.org/Hidden/Economics/FeaturedCategories/Pubs/coding_source.aspx

Both Clinical Examples and Coding Source have discussed 2D v 3D multiple times.


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