Computed Tomography (CAT Scan) and Computed Tomographic Angiography (CTA) of the Abdomen and Pelvis
Summary
Blue Cross and Blue Shield of Alabama policy L.6.01.401 covers CT of the abdomen or pelvis as medically necessary for abdominal or pelvic pain with the listed features, obstructive uropathy, nephrolithiasis or ureterolithiasis, diverticulitis, Crohn's disease, ulcerative colitis, abscess, appendicitis, bowel obstruction, abdominal or pelvic cancer, known or suspected pancreatitis, evaluation of gastrointestinal hemorrhage, suspected bowel perforation, hematuria, and several post-surgical and follow-up indications. CT of the abdomen or pelvis is not medically necessary for all other indications, including screening of asymptomatic patients. CT angiography of the abdomen or pelvis is medically necessary for arterial and venous aneurysm, traumatic injuries to arteries and veins, arterial dissection and intramural hematoma, arterial and venous thromboembolism, vascular interventions, intestinal angina (mesenteric ischemia), evaluation of a renal transplant donor, and acute gastrointestinal bleeding evaluation, among other listed indications. CT angiography of the abdomen or pelvis is not medically necessary for all other indications, including screening of asymptomatic patients. The Code Reference was updated on 10/01/2026 to add ICD-10 codes K6A.01, K6A.09, K74.0A and QA1.792 and to remove ICD-9 codes and the deleted ICD-10 code R10.2. RadSite was added as an imaging accreditation body on 11/01/2025.
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