Radiology Coding Alert
Read Up on 3D Reconstruction
Question: For CPT 76376 and CPT 76377 , does the radiologist have to list the planes in which he reformats the views (coronal, sagittal, multiplanar), and does he have to reformat the views in three or more planes? Is there any official guidance on this? Answer: Careful--be sure you're applying these codes only to 3D rendering, not 2D rendering.
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CPT 2006 added 76376 (3D rendering with interpretation and reporting of computed tomography, magnetic resonance imaging, ultrasound, or other tomographic modality; not requiring image postprocessing on an independent workstation) and 76377 (... requiring image postprocessing on an independent workstation), replacing 76375, which included 2D and 3D reformatting.
CPT 2006 states that "2D reformatting is no longer separately reported." Example: Converting an axial scan into the coronal or sagittal plane is 2D reformatting.
CPT Changes 2006 explains that technological advances have made 2D reformatting a rapid process that should be included in the base procedure code.
CPT guidelines also state that 76376 and 76377 "require concurrent physician supervision of image postprocessing 3D manipulation of volumetric data set and image rendering."
3D image rendering is still a complex process, CPT Changes 2006 explains. The 3D rendering codes address "shaded surface rendering, volumetric rendering, maximum-intensity projections (MIPs), fusion imaging, and quantitative analysis."
Bottom line: The radiologist must document 3D rendering for you to report 76376 and 76377.
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