2025 CPT code 76376
(Active) Effective Date: N/A Revision Date: N/A Diagnostic Imaging Procedures - Diagnostic Radiology Radiology Feed
3D rendering with interpretation and reporting of computed tomography, magnetic resonance imaging, ultrasound, or other tomographic modality with image post-processing under concurrent supervision; not requiring image post-processing on an independent workstation.
Modifiers 26 (professional component) and TC (technical component) may be appended, depending on the services rendered. Payer policies may vary. Modifiers should be used appropriately based on the services rendered. For example, if a physician is interpreting images, the modifier 26 can be used, while modifier TC would be used if billing for the technical component of the service. Refer to the CPT manual and payer guidelines for accurate modifier usage.
The 3D rendering must be medically necessary to enhance the diagnostic information provided by the original imaging study and must improve the quality of patient care. The specific clinical reasons for requiring 3D rendering should be clearly documented.Justification may involve improved visualization for complex anatomical structures, surgical planning, or improved quantitative analysis.
The radiologist or qualified physician is responsible for the interpretation and image post-processing of the 3D rendered images.This includes generating a report detailing findings and clinical implications. The technician is responsible for acquiring the original imaging data. Concurrent supervision by the physician is required.
In simple words: This medical code covers the creation of a 3D image from scans (like CT scans, MRIs, or ultrasounds), along with the doctor's review and report of the 3D image.The doctor works directly with the image, enhancing its details and clarity for diagnosis.This is done on the machine where the scan was originally performed and doesn't require a separate computer.
This CPT code encompasses the 3D rendering, interpretation, and reporting of imaging data obtained from computed tomography (CT), magnetic resonance imaging (MRI), ultrasound, or other tomographic modalities. The procedure includes image post-processing performed under concurrent physician supervision.It is specifically for situations where the post-processing does not necessitate the use of an independent workstation.The provider interprets the images, generates reports, and performs image post-processing to enhance diagnostic capabilities. This process involves the reconstruction of multiple thin-section images to create a three-dimensional image. The benefits of 3D interpretation include improved visualization of complex anatomical structures, enhanced image recovery, better image segmentation, and improved quantitative analysis.
Example 1: A patient presents with a complex fracture of the distal radius. A CT scan is performed, and the radiologist uses code 76376 to create a 3D rendering of the fracture, facilitating precise surgical planning and assessment of fracture reduction., A patient has a suspected brain tumor.An MRI is conducted, and the neuroradiologist uses code 76376 for 3D reconstruction and detailed analysis of the tumor's size, location, and relationship to surrounding brain structures. This informs the neurosurgeon about the surgical approach., A patient presents with abdominal pain. A CT scan is obtained, and the radiologist uses code 76376 to create a 3D reconstruction of the abdominal organs. This aids in visualization of the extent of disease in a patient with suspected inflammatory bowel disease.
* Detailed clinical indication for the 3D rendering.* Type of imaging modality used (CT, MRI, ultrasound, etc.).* Report detailing the 3D rendering findings and their clinical significance.* Confirmation that the post-processing was performed on the scanner and did not involve an independent workstation.
** Always refer to the most current CPT codebook and payer-specific guidelines for the most accurate coding and reimbursement information. Reimbursement for this code may vary depending on payer and location, and is subject to change. Anthem's policy, as of November 8th, 2024, excludes separate reimbursement in most locations.Always verify coverage before providing the service.
- Revenue Code: I4B (IMAGING/PROCEDURE - OTHER)
- RVU: RVUs vary based on payer and geographic location.Check with your local Medicare Administrative Contractor (MAC) or the payer for specific RVU values.
- Global Days: Not applicable. This code describes a post-processing service, not a surgical procedure.
- Payment Status: Active, but reimbursement policies vary significantly by payer. As of December 3, 2024, Anthem does not provide separate reimbursement for this code, except for facility providers in Connecticut.
- Modifier TC rule: Modifier TC (technical component) may be applicable under certain circumstances, particularly if billing for only the technical aspect of the service. However, payer-specific policies may vary.
- Fee Schedule: Historical fee schedules vary significantly by payer, geographic location, and year.This information is not readily accessible in a centralized database and is subject to constant change.
- Specialties:Radiology, Neuroradiology, Interventional Radiology, other specialties depending on the context of the imaging performed.
- Place of Service:Office, Hospital (Inpatient or Outpatient), Ambulatory Surgery Center, Imaging Center