The impact of regulation, reimbursement, and research on the value of 3D printing and other 3D procedures in medicine

Table 3 Symptomatic Hearing Loss and Vertigo – Differential Diagnosis includes Vestibular Schwannoma. Surgical Planning for a Hypothetical Patient includes MRI and CT

Procedure	Appropriateness	Billing code(s)
MRI with and without contrast	Usually appropriate [18]*	70553
CT with and without contrast	May be appropriate [18]*#	70482
3D visualization	NA (secondary code)	73677&
Virtual reality	TBD	None
3D printed anatomic model	TBD	0559T + 0560T

*Refers to the appropriateness rating in the American College of Radiology (ACR) Appropriate Use Criteria (AUC) where the MRI is rated “Usually appropriate” and CT is rated “May be appropriate”. # ACR AUC only considers initial imaging evaluation, and thus the CT scan is scored "May be appropriate". Because of the exponential complexity, the ACR does not nest AUC to provide recommendations after the initial imaging is complete. However, given the diagnosis of vestibular schwannoma from the MRI, the CT to better assess the skull base is routinely performed and I expect it would be reimbursed. & The secondary code 73677 may be added to the MRI or the CT scan. However, if either is performed an an angiography, 73677 could not be added.

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