Pediatric Chest Imaging

This policy covers pediatric chest imaging and diagnostic strategies (using the eviCore Clinical Decision Support tool) including radiography, CT, MRI (e.g., CPT 71550/71551/71552), and select nuclear studies for common pediatric chest symptoms and conditions such as pneumonia, bronchiolitis, cystic fibrosis/bronchiectasis, hemoptysis, mediastinal masses, lymphadenopathy, solitary pulmonary nodule, TB/PPD, asthma, pectus deformities, breast masses, vascular malformations and congenital cystic lung disease. Major limitations/requirements: it applies only to the pediatric population (patients ≥18 follow adult guidelines unless otherwise noted), atypical presentations require physician review, advanced imaging generally requires a recent (≤60 days) face‑to‑face evaluation, screening of asymptomatic patients and unnecessary repeat studies are not supported, MRI contrast use is restricted with anesthesia typically required for children <7 years or those with developmental delays, and several CT/MR/PET codes are rarely used or limited in pediatrics.