3D post-processing is required and is included in computed tomographic angiography

Q.

We perform quite a few Computed Tomography (CT) 3D post-processing exams. Currently, I don’t believe we use the specific CPT^® codes for 3D rendering; 76376 & 76377. Can you tell me when and how these CPT codes should be used? If a regular CT (not a CTA) is performed, and 3D post-processing is performed under concurrent physician (or other qualified healthcare provider (QHP) supervision, then you would assign CPT code 76376 if the post-processing was performed on the CT machine itself, or CPT code 76377 if the post-processing is done on a separate dedicated workstation. 

A.

The radiologist doesn’t have to personally perform the 3D post-processing but must be involved in the process by actively participating in and monitoring the process, including: 

• Design of the anatomic region that is to be reconstructed;
• Determination of the tissue types and actual structures to be displayed (e.g., bone, organs, and vessels);
• Determination of the images or cine loops that are to be archived; and
• Monitoring and adjustment of the 3D work product;

Documentation should support the physician or QHP supervision of the process. 

Multiplanar reconstructions are not necessarily 3D. CPT codes 76376 and 76377 include complex renderings such as shaded surface rendering, volumetric rendering, quantitative analysis (segmental volumes and surgical planning), and maximum intensity projections when such renderings can be performed on the scanner or when it requires the use of an independent workstation.

3D post-processing is required and included in computed tomographic angiography (CTAs), so CPT codes 76376 or 76377 would not be separately coded with any CTA code.