Abdomen Imaging Guidelines

This policy covers abdominal imaging—primarily CT of the abdomen and abdomen/pelvis (including CT enterography when indicated)—for evaluation of common abdominal symptoms and conditions such as abdominal pain, suspected abscess/sepsis, renal/ureteral stones, mesenteric ischemia, post‑operative pain, trauma, aneurysm surveillance, masses, hernias and many other abdominal indications. Coverage requires a current clinical evaluation (usually within 60 days), appropriate prior/ancillary testing and conservative management when applicable, typically favors contrast‑enhanced CT (with non‑contrast limited to renal insufficiency or documented contrast allergy), and restricts routine 3D rendering unless explicitly documented in the final radiology report; atypical presentations not addressed by the tool require physician review.

"AB-12: Hernias"

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