Current Clinical Concerns in CT: Results : Reimbursement
3D billing
1. How are people handling VC reimbursement? (2 Individuals asked this question)
| Answer: At the present time, the ACR is working on obtaining appropriate reimbursement. In some states, insurance is beginning to pay. |
2. When scanning a patient for a CT angiogram, say a Renal Donor, are we able to bill for a regular CT Abdomen and a CT Angiogram Abdomen? How do you code CTAs? (Two individuals posed this question)
| Answer: The ACR just updated the CTA codes and reimbursement levels. Please contact them for specific coding rules which should meet your needs. (Dated 5/03) |
3. When you read a CT study from a 3D volume rendered model, do you always bill for the 3D (cpt 76375)? What % reimbursement do you receive?
| Answer: The reimbursement is variable. As long as the physician requests it, we will bill for it. |
4. What series of CPT codes do you use for a complete 3 phase hematuria study with 3D?
| Answer: We bill it as a 3 phase kidney. |
5. Is 3D reconstruction being paid for? How should it be appropriately billed? Should the code be used only once, i.e. on an abdomen and pelvis?
| Answer: The ACR has a coding system that we usually use. We also use a 6070 code modifier. We bill once for a 3D even if it includes abdomen and pelvis. This is the usual case is patients with aortic aneurysms, for example. |
6. Our facility is contemplating acquiring a 16-slice GE upgrade, but administration is not quite convinced that a 16-slice can produce considerably better exams. How can we assure them that we can get reimbursements on Cardiac studies, and other specialized MDCT exams that require 3D and Volume rendering?
| Answer: 16 slice is required for quality patient care, and reimbursements are beginning to follow. You can have your administrator call me personally. |