Radiology Coding Alert

You can't choose between 76376 and 76377 without this documented detailCorrect Coding Initiative (CCI) version 14.0 added to the already bulky list of 3-D rendering edits, keeping you on your toes when you're considering reporting these codes. Now's the perfect time to take a look at what's new and be sure you're up on the other can't-miss 3-D rendering rules.Rule 1: Remember 1 Word Separates 76376 and 76377CPT 2006 added the following 3-D rendering codes:• 76376 -- 3-D rendering with interpretation and reporting of computed tomography, magnetic resonance imaging, ultrasound, or other tomographic modality; not requiring image postprocessing on an independent workstation• 76377 -- ... requiring image postprocessing on an independent workstation.For 76376, which does not require an independent workstation, the physician discusses the need for 3-D imaging with the technologist and supervises the images' creation. For 76377, which does require an independent workstation, the physician supervises or creates the 3-D image and adjusts the projection for optimal anatomy and pathology visualization, says Michael Longacre, a consultant with HealthCare Market Strategies Inc. in Yamhill, Ore., citing ACR 2006 Coding Update.Documentation tip: The only way that you can tell which code to report is if the radiologist documents independent workstation use (or nonuse), says Jackie Miller, RHIA, CPC, senior consultant with Coding Strategies Inc. in Powder Springs, Ga.Rule 2: Stop Trying to Report 2-D ReconstructionCPT added the 3-D rendering codes for complex renderings, including shaded surface rendering and maximum intensity projections (MIPs), fusion of images from other modalities and quantitative analysis (segmental volumes and surgical planning), Longacre says, citing the AMA's CPT Changes 2006: An Insider's View.Remember: You should not separately report 2-D reconstruction, Longacre says. This change occurred in 2006 when CPT replaced 76375 (Coronal, sagittal, multiplanar, oblique, 3-dimensional and/or holographic reconstruction of computed tomography, magnetic resonance imaging, or other tomographic modality) with 76376 and 76377.So even if your radiologist documents constructing coronal, sagittal, multiplanar or oblique reformats from axial images, remember that these are 2-D, and you should not report them separately, says Stacie Buck, CCS-P, LHRM, RCC, vice president of Southeast Radiology Management.Rule 3: Strive for Crystal-Clear DocumentationProblem: "Our customers and advisers have indicated that a significant proportion of their 3-D procedures are not properly coded, billed or reimbursed," says Pierre Lemire, president and CTO of Calgary Scientific Inc. Medical Group, a 3-D advanced visualization software developer.One factor is that documentation doesn't clearly support coding 76376 and 76377.Helpful: Technological solutions that integrate software more tightly into billing and reimbursement workflow may help you keep track of documentation musts, boosting coding efficiency and reimbursement ratios. Example: Calgary Scientific is looking into IHE- and HL7-compatible audit trails and automated, structured reporting tools to help providers include all required orders to substantiate your [...]