In 2006, two new post-processing CPT codes were introduced, replacing the troublesome 2D/3D rendering code 76375.
The new codes were 76376 and 76377 both used to report 3D rendering postprocessing. The difference between them is 76376 does not require postprocessing on an independent workstation whereas 76377 does require the use of an independent workstation. These codes are separately-reportable in addition to the base imaging procedure(s) in cases where the CPT code for the base procedure doesn’t already contain image postprocessing as listed below according to the American Medical Association’s 2013 CPT.
76376 3D rendering with interpretation and reporting of computed tomography, magnetic resonance imaging, ultrasound, or other tomographic modality with image postprocessing under concurrent supervision; not requiring image postprocessing on an independent workstation
• Report 76376 in conjunction with codes(s) for base imaging procedure
• Do not report 76376 in conjunction with 31627, 70496, 70498, 70544-70549, 71275, 71555, 72159, 72191, 72198, 73206, 73225, 73706, 73725, 74174, 74175, 74185, 74261-74263, 75557, 75559, 75561, 75563, 75565, 75571-75574, 75635, 76377, 78012-78999, 0159T
76377 3D rendering with interpretation and reporting of computed tomography, magnetic resonance imaging, ultrasound, or other tomographic modality with image postprocessing under concurrent supervision; requiring image postprocessing on an independent workstation
• Report 76377 in conjunction with code(s) for base imaging procedure
• Do not report 76377 in conjunction with 70496, 70498, 70544-70549, 71275, 71555, 72159, 72191, 72198, 73206, 73225, 73706, 73725, 74174, 74175, 74185, 74261-74263, 75557, 75559, 75561, 75563, 75565, 75571-75574, 75635, 76376, 78012-78999, 0159T
Concurrent means active participation in and monitoring of the reconstruction process that includes: design of the anatomic region that is to be reconstructed; determination of the tissue types and actual structures to be displayed; determination of the images that are to be archived; and monitoring and adjustment of 3D work product.
Documentation is the key to proper coding of 3D rendering studies.
• The only way to know which 3D rendering code to use will be the documentation in the report. The use of an independent workstation for 76377 or the nonuse for 76376 must be clearly identified.
• Either in a separately-identifiable section of the report or an entirely separate report, document the 3D rendering and what it showed independent of the original exam.
• As image reformatting is not typically performed on every imaging procedure routinely, carriers will base reimbursement on medical necessity.
• Coverage for these procedures in some states is further guided by a CMS Local Coverage Determination (LCD) which provides eligible diagnosis guidance as well as additional limitations that direct payment. Some of the states that do have an LCD for 3D Reconstruction services follow with their corresponding links to the LCD on CMS’ website.
San Francisco, CA