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Reformatted/reconstructed exam

  1. #1
    Question Reformatted/reconstructed exam
    Medical Coding Books
    if an exam is reformatted/reconstructed from an exam that was peformed with contrast, would the reformatted/reconstructed exam be coded with contrast also? Then if an exam is reformatted/reconstructed from an exam that was performed without contrast, would the reformatted/reconstructed exam be coded without contrast also? Or, are all reformatted/reconstructed exams coded as without contrast irregardless?

  2. #2
    Mobile, Alabama
    are you referring to 2D and 3D reconstruction? CPT 76376 and 76377.

  3. #3
    no, I am talking about when the radiologist does a CT adomen and pelvis with conrast and then reconstructs/reformats a CT lumbar spine. Would the lumbar spine be with or without contrast?

  4. #4
    Mobile, Alabama
    Per my radiologist, the CT Lspine would be considered without contrast.

  5. #5
    If done in sequence with the CT Abd then you could look at it as the patient does have the contrast in them from the previous exam so you would see it as CT Lumbar with contrast but you would not charge for the contrast twice the same day. Just looking at it from another point of view.

  6. #6
    Mobile, Alabama
    Of course if your protocol is oral contrast given for the CT Abdomen, that will not relate to the Lspine.

    If we do a CT pelvis with contrast then add another modality (CT Chest) to the series, then we have to up our ml on contrast.

    Example: CT Pelvis 74193, contrast Q9967 100ml
    CT Chest 72160, contrast Q9967 50ml
    3D recon 76377

    I think it all relates to how your radiologist interprets the scan and what the your protocol is. Most all radiologist do things differently. Like I said above, our protocol is the patient gets an oral contrast for the abdomen and IV contrast for the pelvis.

  7. #7
    So you are saying that you charge for 2 contrasts in one day? One being 50 and the other 100 to the same carrier? And you are getting paid for both?

  8. #8
    Mobile, Alabama
    yes, the NDC numbers are different for each one.

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