Pediatric Chest Imaging

Advanced pediatric chest imaging (CT/MRI/US/PET/MRA/MIBG) is covered only for specified symptomatic indications (eg mediastinal mass, lymphadenopathy, hemoptysis, CF complications, pre/post‑transplant planning, suspected PE if CT unavailable) and excludes routine screening of asymptomatic children and most repeat studies. Key requirements are documented pertinent clinical evaluation (history/physical, labs), prior basic imaging (CXR/US) unless an exception applies, adherence to modality‑specific limits (avoid MRI with anesthesia for large anterior mediastinal masses; limit GBCA use; single repeat CT allowed only if no anterior mass, enlarged nodes, lymphopenia or pleural effusion), and indication‑specific documentation (eg CXR before CT for mediastinal mass, CT/PET/MIBG documentation before biopsy for suspected lymphoma/neuroblastoma).

"Fine needle aspiration is inappropriate for evaluating lymphadenopathy in pediatric patients (supraclavicular adenopathy context)."