Chest Imaging Guidelines

This policy covers chest imaging services—including chest radiography, CT (including high‑resolution protocols), ultrasound, and occasional MRI—for evaluation of common thoracic symptoms and conditions such as cough, dyspnea, hemoptysis, chest pain, lymphadenopathy, COPD, bronchiectasis, interstitial lung disease, pneumonia/COVID‑19, solitary pulmonary nodules, pleural disease, pneumothorax, mediastinal masses, asbestos exposure, and suspected thoracic malignancy. Major limitations/requirements include a pertinent clinical evaluation (telehealth/phone/email allowed only for established patients), expectation of a recent chest x‑ray with comparison to prior films before advanced imaging, physician review for atypical presentations, and billing/technical constraints (e.g., HRCT slices are not separately billable).

"Chest ultrasound: CPT® 76604"

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