December 21, 2018

Q&A: Billing CT Spine Reconstruction from Previous CT Data Set

Question: A trauma patient is seen in the emergency department (ED). The provider orders CT studies of the chest, abdomen, and pelvis with intravenous contrast. The CT studies are performed and the patient is then admitted to the hospital. Later the same day, the trauma service orders CT scans of the thoracic and lumbar spine. These are performed by reconstructing the CT scan data from the previously acquired CT scans of the chest, abdomen and pelvis. How should the technical and professional components of the T-spine and L-spine reconstructed images be reported?

Answer: If CT studies of the chest, abdomen and pelvis with intravenous contrast are ordered and performed, it is appropriate to report for both the technical (TC) and professional component (26) for CT scans of the chest (71260 Computed tomography, chest; with contrast material) and CT of the abdomen and pelvis (74177 Computed tomography, abdomen and pelvis; with contrast material). If reconstructions of the thoracic and lumbar spine are ordered and the images reconstructed from the original CT data sets, it is appropriate to report the professional components for interpretations of the spine CT scans; the technical component is not reported, as it is considered included in the initial CT procedure. For example, in this scenario it is appropriate to report code 72129 Computed tomography, thoracic spine; with contrast material and code 72132 Computed tomography, lumbar spine; with contrast material with -26 modifiers to designate that only the professional components are being reported.