Chest Imaging Guidelines

Covers chest x‑ray, ultrasound, CT (noncontrast/contrast/HRCT/CTA/LDCT), MRI and nuclear lung studies for specific indications (cough, dyspnea, hemoptysis, nodules, ILD, infections, pleural disease, trauma, mediastinal/chest wall masses, PE, transplant assessment and lung cancer screening) but excludes routine CT for uncomplicated rib fractures, bronchitis beyond chest x‑ray, CT screening for asbestos or asymptomatic COVID‑19 donors, routine MRI for chest pain, routine PET/CT for ground‑glass/subsolid nodules or sarcoidosis screening, and discourages serial CT/PET when prior imaging is stable. Advanced imaging generally requires a pertinent clinical evaluation and often a radiologist‑overread chest x‑ray (or other specified prior tests) with modality‑specific documentation (e.g., PE: symptoms plus abnormal D‑dimer/Wells/high‑risk factor; non‑smoker cough: documented 3‑week therapeutic trial and PFTs; hemoptysis/dyspnea: chest x‑ray and additional testing) and adherence to specified follow‑up intervals, biopsy guidance, and other limitations.