CommercialCoverageHigh impact
Computed Tomography (CAT Scan) and Computed Tomographic Angiography (CTA) of Extremity or Joint
Blue Cross & Blue Shield of Mississippi·MS · Emergency Medicine, Radiology, Orthopedics +2 more·Medical Policy
We identified it
Jun 20, 2026
Summary
This is a new comprehensive medical policy defining coverage criteria for CT scans and CT angiography of extremities and joints. It establishes specific medical necessity requirements for different anatomical areas and requires network providers to have proper accreditation (IAC, ACR, or RadSite) for billing the technical component of CT services.
Action Required
Immediately: Verify all network providers performing CT scans of extremities/joints have current accreditation from IAC, ACR, or RadSite. Update prior authorization and coverage determination workflows to align with the specific medical necessity criteria outlined for each anatomical area (knee, shoulder, TMJ, hip, upper/lower extremities). Ensure billing staff can verify indications match policy requirements before claim submission to prevent denials.