Question:

My radiologist is reading an MRI Prostate and 3D reconstruction. My question is can we bill for the 3D? My understanding is that there should be an order from referring MD for the 3D. Also what type of reporting needs to be documented for the 3D. We are just billing for the professional component using modifier 26 as he is independent from the facility/IDTF where performed.

Answer:

If your doctors are not involved when the 3D reconstructions are performed, then you can’t code 76377. If your techs are doing the 3D based on protocol, without active involvement by a physician, then you don’t meet the “concurrent” part of the requirements. After all, “concurrent” means “at the same time” – a protocol written in the past does not fit.

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