Radiology Coding Alert

The task of appropriately assigning CPT Codes 's reconstructive view code sometimes trips up radiology coders who forget how to use these pivotal add-on codes.

According to Stacie L. Buck, RHIA, compliance officer for U.S. Diagnostic Inc., a corporation in West Palm Beach, Fla., that owns and operates diagnostic imaging centers in several states, confusion about 76375 (Coronal, sagittal, multiplanar, oblique, 3-dimensional and/or holographic reconstruction of computerized axial tomography, magnetic resonance imaging, or other tomographic modality) can be erased by keeping the following tips in mind. 1. Understand what a reconstructive view is. Code 76375 describes computer-generated enhancements conducted after a diagnostic imaging study has been completed, says Patti Offner, RT, with Diagnostic Imaging Inc. in Philadelphia. "After images are taken, they are reformatted in a different projection using special software. It is an additional step beyond the basic procedure and is performed by the radiologist to further define an area of interest." Original CT, MRI, positron emission tomography (PET) or single photon emission computed tomography (SPECT) images are manipulated to reveal additional and different views that may expose an abnormality or anatomic relationship not easily seen on the original images or projection.

Reconstruction views may include:

Coronal divides the body, or body section, into front and back planes or portions
Sagittal divides the body, or body section, into left and right planes or portions
Multiplanar revealing several planes
Oblique providing a slanted or diagonal view
Three-dimensional giving the illusion of having depth
Holographic images producing a picture in which the image appears as a three-dimensional representation of the original object.   2. Recognize that 76375 is an add-on code. Many coders mistakenly report a reconstructive view by itself, Offner says. However, it must be reported with the proper modality and anatomic site. A radiologist may perform a CT of the cervical spine, for instance, with reconstruction in the sagittal plane on a trauma case. Coders may report both a cervical spine CT code (e.g., 72126, Computerized axial tomography, cervical spine; with contrast material) and 76375. 3. Don't confuse views inherent in the original study with reconstructive images. The views listed in the reconstruction code descriptor (e.g., sagittal or coronal) may also be directly obtained during the basic study itself, Buck says. For instance, a coronal view may be standard acquisition during a CT scan. Therefore, references to these views in the radiology report do not automatically indicate that reconstruction took place. They may simply reflect the planes in which images were generated. To justify the addition of 76375, the radiologist must have reformatted the images after the [...]