A: It is not appropriate to report the technical component (TC) or the professional component (PC) of CPT codes 76376 (3D rendering with interpretation and reporting of computed tomography, magnetic resonance imaging, ultrasound, or other tomographic modality; not requiring image post-processing on an independent workstation) or 76377(3D rendering with interpretation and reporting of computed tomography, magnetic resonance imaging, ultrasound, or other tomographic modality; requiring image post-processing on an independent workstation) when the reconstruction of images is performed without concurrent physician supervision.
As stated in the Q&A published in the November-December 2006 issue of the ACR Radiology Coding Source™ , the Winter 2006 issue of Clinical Examples in Radiology, and on page 370 of the CPT 2012, Professional Edition code book, concurrent physician supervision is required for the reporting of the three-dimensional (3D) codes 76376 and 76377. It is not required to document physician involvement; however, the College recommends that it is best to document the physician’s supervision or participation in the 3D reconstruction of images in case of an audit, and to distinguish from those cases where the physician is not involved.
Per the AMA/ACR Clinical Examples in Radiology, Concurrent physician supervision, as noted in the new 3D codes 76376 and 76377, defines a temporal relationship to creating the 3D volume rendered images. Concurrent means active participation in and monitoring of the reconstruction process that includes: design of the anatomic region that is to be reconstructed; determination of the tissue types and actual structures to be displayed (eg, 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.
Concurrent does not relate to the definitions for general, direct, and personal supervision that have been established by the Centers for Medicare and Medicaid Services, which relate to the physical location of the physician with respect to the patient and would apply to the computed tomography acquisition base procedure code.