CurrentFlorida BluePolicy 10-001

3D Rendering of Tomographic Modalities

Defines Florida Blue's reimbursement stance for separate billing of 3D rendering (CPT 76376, 76377) for tomographic modalities on CMS-1500 or equivalent claim forms; applies to all lines of business and providers rendering services to BCBSF members.

Policy Summary

PayerFlorida Blue

Policy3D Rendering of Tomographic Modalities

Policy CodePolicy 10-001

Change TypeNo material change

Effective DateFeb 24, 2010

Next Review Date

Key ActionDo not bill separately for CPT 76376 or 76377; these codes are not eligible for separate reimbursement.

SourceLink

POLICY UPDATE CHANGES

No material clinical or coverage changes in this revision.

2CPT codes listed for 3D rendering

All linespolicy applicability

CMS-1500billing form specified

Appeals not acceptedoverride attempts

Coverage rules for 3D rendering

Covered when ALL of the following are met:

ALL of the following

Policy stance
- 3D rendering (CPT 76376, 76377) is considered a technology/technique improvement that is an aid to the physician and is not eligible for separate reimbursement.
Modifier guidance
- Separate visual enhancements reported with CPT 76376 and 76377 are not eligible for separate reimbursement even when reported with modifier 59.
Billing and provider definition

Policy Summary

PayerFlorida Blue

Policy3D Rendering of Tomographic Modalities

Policy CodePolicy 10-001

Change TypeNo material change

Effective DateFeb 24, 2010

Next Review Date

Key ActionDo not bill separately for CPT 76376 or 76377; these codes are not eligible for separate reimbursement.

SourceLink

On This Page

Relevant CPT codes for 3D rendering

3D rendering CPT codesCPTNot Covered

76376	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.
76377	3D rendering with interpretation and reporting of computed tomography, magnetic resonance imaging, ultrasound, or other tomographic modality; with image post-processing under concurrent supervision; requiring image post-processing on an independent workstation.

Definitions

inv-04: 3D rendering

Definition3D rendering: computer-generated three-dimensional reconstruction and display of structures or anomalies from primary imaging studies (CT, MRI, PET, microscopy, ultrasound).

MethodBuilt from the primary imaging study using computer software and graphics programs to extract and display structures of interest as three-dimensional models.

Applicable modalitiesCT, MRI, PET, microscopy, and ultrasound.

Billing contextApplies to billing for services on a CMS-1500 or equivalent claim form.

inv-05: Same provider

DefinitionSame provider: all physicians and/or other health care professionals reporting under the same Federal Tax Identification number for purposes of this policy.

PurposeUsed to determine whether separate reimbursement or billing rules apply when multiple clinicians are involved in a patient’s imaging and post-processing services.

Claim form referenceSame provider definition applies for services billed on a CMS-1500 or equivalent claim form.

OpenPayer

3D Rendering of Tomographic Modalities

Coverage rules for 3D rendering

Relevant CPT codes for 3D rendering

Billing and appeal actions for providers

Definitions