How To Use CPT Code 0561T

CPT 0561T describes the creation of an anatomic guide using 3D printing technology based on image data sets. This article will cover the official description, procedure, qualifying circumstances, appropriate usage, documentation requirements, billing guidelines, historical information, and examples.

1. What is CPT Code 0561T?

CPT 0561T can be used to report the creation of an anatomic guide using 3D printing technology. This code is specifically used for the first anatomic guide that is printed from one or more image data sets. The guide is designed to assist in surgical procedures by conforming to the individual patient’s anatomy.

2. Official Description

The official description of CPT code 0561T is: ‘Anatomic guide 3D-printed and designed from image data set(s); first anatomic guide.’

3. Procedure

1. The healthcare provider uses individualized image data sets and a 3D printer to create the first anatomic cutting or drilling guide.
2. The guide is designed to match the patient’s unique anatomy and is printed using 3D printing technology.
3. The anatomic guide is then used during surgery to assist the healthcare provider in performing precise cutting or drilling procedures.
4. It is important to note that each cutting guide is a single tool without multiple parts.

4. Qualifying circumstances

CPT 0561T is used when a healthcare provider creates the first 3D anatomic cutting or drilling guide using image data sets and a 3D printer. This code should not be reported in conjunction with codes 76376 or 76377. It is important to check with the payer to determine coverage for this procedure, as it may be considered investigational or not yet approved by the FDA.

5. When to use CPT code 0561T

CPT code 0561T should be used when the healthcare provider creates the first anatomic guide using 3D printing technology. This code should not be used for subsequent guides. If additional anatomic guides are created for the same patient, report code 0562T in addition to 0561T for the primary procedure.

6. Documentation requirements

To support a claim for CPT code 0561T, the healthcare provider must document the following information:

• Individualized image data sets used for creating the anatomic guide
• Date of the procedure
• Details of the 3D printing process
• Explanation of how the anatomic guide conforms to the patient’s anatomy
• Signature of the healthcare provider performing the procedure

7. Billing guidelines

When billing for CPT code 0561T, ensure that the procedure involves the creation of the first anatomic guide using 3D printing technology. It is important to note that this code should not be reported with codes 76376 or 76377. It is recommended to check with the payer regarding coverage and reimbursement for this procedure.

8. Historical information

CPT code 0561T was added to the Current Procedural Terminology system on an unknown date. There have been no updates to the code since its addition.

9. Examples

1. A surgeon uses image data sets and a 3D printer to create the first anatomic guide for a complex orthopedic procedure.
2. A maxillofacial surgeon utilizes 3D printing technology to produce the initial anatomic guide for a reconstructive surgery.
3. An interventional radiologist creates the first anatomic guide using 3D printing for a minimally invasive procedure.
4. A neurosurgeon employs the use of image data sets and a 3D printer to generate the first anatomic guide for a delicate brain surgery.
5. An oral and maxillofacial surgeon utilizes 3D printing technology to create the initial anatomic guide for a jaw reconstruction procedure.
6. A plastic surgeon uses image data sets and a 3D printer to produce the first anatomic guide for a complex facial reconstruction surgery.
7. An orthopedic surgeon employs the use of 3D printing technology to create the initial anatomic guide for a joint replacement procedure.
8. A cardiovascular surgeon utilizes image data sets and a 3D printer to generate the first anatomic guide for a complex heart surgery.
9. A urologist creates the first anatomic guide using 3D printing for a precise prostate surgery.
10. A gynecologist employs the use of image data sets and a 3D printer to produce the initial anatomic guide for a complex pelvic surgery.