Chest X-Ray Policy

Chest X‑rays are covered (reasonable and necessary) when ordered for signs/symptoms or relevant history that will affect diagnosis or treatment (e.g., symptomatic cardiac/pulmonary disease, chest/upper‑abdominal trauma, or selective preoperative evaluation with cardiac/respiratory symptoms or high‑risk surgery) and are not covered for routine screening, routine preoperative use without symptoms, minor non‑thoracic trauma, or other situations lacking relevant signs/symptoms. Key requirements: the chart must document medical necessity (specific signs/symptoms or relevant history/provisional diagnosis and how the X‑ray results will be used to guide care), otherwise the exam is not payable.

"Radiographs of the chest ."

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