For proper reporting of CTA exams, there is a well-documented list of acceptable 3D techniques to satisfy the code requirement. These are 3D MIP, surface-shaded rendering, and volume rendering, as well as “other 3D techniques.” We’ve come across dictations that state 2D MIPs. Is this a type of 3D technique?
For proper reporting of CTA exams, CPT requires that 3D postprocessing be performed using techniques that qualify as 3D imaging, such as 3D maximal intensity projection (MIP), surface-shaded rendering, or volume rendering, as well as other emerging 3D methods. While MIP is derived from volumetric data and produces a series of 2D images, it is considered a valid 3D postprocessing technique when the reconstruction is performed and interpreted as part of a 3D analysis, consistent with AMA guidance. Therefore, a dictation that simply states “2D MIPs” does not automatically meet the CPT definition of 3D postprocessing. To report CTA properly, the radiologist must document that the MIP was performed as a 3D reconstruction for interpretation and clinical decision-making. Without such documentation, the 3D requirement for CTA codes is not satisfied, and the study may only qualify as a standard CT rather than a CTA with 3D postprocessing.
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