Radiology Coding Alert

3-D rendering reimbursement appears to be declining, but if you code for a facility, you have a chance to capture more dollars if you play your cards right. Here's the scoop.

A relative vale unit (RVU) decrease, implemented over four years (ending in 2010 with the "fully implemented" RVUs in the chart below), continues to affect 3-D rendering codes, says Michael Longacre, a consultant with HealthCare Market Strategies Inc. in Yamhill, Ore. He offers this chart based on the 2008 conversion factor of 39.792, confirmed for Jan. 1 to June 31. (The conversion factor is slated to drop to 33.880 in July, although many believe Congress will revisit the conversion factor before then.)

Hospital note: For the hospital outpatient prospective payment system (OPPS), CMS changed 76376 and 76377 from separate payment to no separate payment, meaning OPPS packages 3-D payment into that for other services, Longacre says.

CMS explained this decision by saying that the median cost of the originating test reflects the image postprocessing cost. And as, for example, the frequency of 76376 reported with 70450 (Computed tomography, head or brain; without contrast material) increases, the median cost for 70450 will reflect the additional cost for 76376, Longacre says, citing OPPS regulation CMS-1392-FC, page 188.

Lesson: Hospital outpatient facilities need to accurately report 3-D use and make sure the chargemaster reflects the added costs to increase the chance that payers will adequately reimburse rendering services, Longacre says.