Chest Imaging Guidelines

The eviCore Chest Imaging Guidelines authorize modality-specific chest imaging (x‑ray, US, CT/CTA/HRCT, MRI, PET, V/Q) for a wide range of thoracic conditions with clear inclusions (e.g., LDCT lung cancer screening per strict criteria, HRCT for ILD, PET for solid nodules ≥8 mm or select lymphadenopathy) and exclusions/limits (no CT screening for asbestos, PET not routine for sarcoid or for infiltrates/GGO, no serial PETs, and no advanced imaging for uncomplicated bronchitis/COPD exacerbations). Key requirements: a pertinent clinical evaluation and usually a radiologist‑read chest x‑ray within ~60 days (with specified exceptions such as supraclavicular nodes, known bronchiectasis, suspected ILD/TB/AVM), plus documentation of prior imaging comparisons, relevant labs/tests (e.g., D‑dimer, PFTs), biopsy/pathology or specialist consults when indicated, and adherence to size‑ and risk‑based follow‑up algorithms.

"Advanced chest imaging is not typically indicated in COPD exacerbation."