Radiology Question for the Week of July 26, 2021

Question:

If “MIP” is stated within the documentation, is that enough to support billing for 3D post-processing? If so, if the location that performed the Technical Component of this exam was not part of the official registry and an independent group of radiologists interpreted and billed for the professional reads for these studies is the radiology group at risk of potentially having to reimburse CMS (Medicare) for the services related to this code?

Answer:

One of the terms that are mentioned by the AMA to satisfy the billing of code 76376 or 76377 regarding 3D post-processing is MIPs. Assuming there is a medical necessity as well as a request and documentation to support the assignment of this code, this is one of the terms that help to support the assignment of a 3D post-processing code. These codes represent complex renderings including shaded surface, volumetric rendering, quantitative analysis (segmental volumes and surgical planning), and maximum intensity projections (MIPs). They are not assigned when coronal, sagittal, multiplanar or oblique reformats are constructed from axial images. It is imperative that the report include terminology specific to the intent of these codes. (Clinical Examples in Radiology, Volume 2, Issue 1, Winter 2006). When reporting the correct CPT code for the 3D analysis (76376 or 76377), be sure to document within the radiology report whether the 3-D was performed on an independent workstation or on the acquisition scanner. Making an explicit statement within the radiology report will avoid ambiguity and aid the coder in accurately coding for the 3D reconstruction. Some practices may separately document this in the patient’s electronic medical record, but not actually in the report. (Clinical Examples in Radiology, Volume 5, Issue 4; Fall 2009).

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