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American Medical Association approves reimbursement codes for 3D printed surgical models and tools

A series of recently approved codes by the American Medical Association (AMA) will help to push the adoption and use of 3D printing for clinical applications and healthcare. The new codes—consisting of four current procedural terminology (CPT) category III reimbursement codes, came into effect on July 1.

In the medical field, the benefits of 3D printing are becoming increasingly obvious, especially when it comes to printing patient-specific anatomical models and personalized surgical tools. Having access to medical models that are based on a patient’s CT imaging data or tools that are designed for a specific operation, makes it easier for medical professionals to prepare for and plan medical procedures.

The new codes approved by the AMA are expected to promote the use of 3D printing in the medical field. According to Dr. Jane Matsumoto of the Mayo Clinic who spoke at the Society for Imaging Informatics in Medicine (SIIM) annual meeting (as reported by Aunt Minnie), the technology can benefit many medical professionals, including radiologists, clinicians and engineers.

AMA reimbursement codes
axial3D presented a 3D printed kidney model at SXSW 2019

The recently approved codes are the following:

  • Codes 0559T and 0560T: these address reimbursement for the production of individually prepared 3D printed anatomical models that are made up of one or more components with different colors and materials.
  • Codes 0561T and 0562T: these codes deal with the production of personalized 3D printed cutting or drilling tools, which are designed based on patient imaging data. These tools are custom printed and serve surgeons in the operating room.

Significance of the codes

The CPT category III codes are all temporary, but they do still carry import in the medical field. That is, they lay the groundwork for 3D printing nomenclature—something which the American College of Radiology (ACR) and RSNA have been working on for some time. Specifically, the organizations are building a registry to compile and collect 3D printing data in hospital settings. According to Aunt Minnie, until the registry or similar system is in place, the category III codes will serve as “place holders.”

The 0559T and 0561T codes will also introduce reimbursement by the U.S. Centers for Medicare and Medicaid (CMS) for 3D printed models and instruments. This support is expected to influence insurance companies to follow suit and offer reimbursement for the codes. At this point, clinicians are advised to clearly document the entire 3D printing process, from segmenting to producing the models, so that they can be properly reimbursed.

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Tess Boissonneault

Tess Boissonneault moved from her home of Montreal, Canada to the Netherlands in 2014 to pursue a master’s degree in Media Studies at the University of Amsterdam. It was during her time in Amsterdam that she became acquainted with 3D printing technology and began writing for a local additive manufacturing news platform. Now based in France, Tess has over two and a half years experience writing, editing and publishing additive manufacturing content with a particular interest in women working within the industry. She is an avid follower of the ever-evolving AM industry.

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