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Blue Cross & Blue Shield of MississippiAll Plans · Coverage · Medical Policy · Radiology, PulmonologyMedium impact

Computed Tomography (CAT Scan) and Computed Tomographic Angiography (CTA) of the Chest and Thorax

Effective date
Not stated in the notice
Identified
Jun 20, 2026

Summary

Blue Cross and Blue Shield of Alabama considers CT scans of the chest and thorax medically necessary for indications including cough, hemoptysis, vocal cord paralysis or hoarseness, unexplained wheezing, abnormal findings on prior chest imaging, suspected pulmonary embolism based on clinical assessment and pre-test probability testing, metastases to the lung or mediastinum, known primary or metastatic lung or mediastinal tumors, interstitial lung disease, suspected thoracic aortic dissection, and evaluation of chest trauma. Computed tomographic angiography (CTA) of the chest and thorax is considered medically necessary for indications including suspected pulmonary embolism, developmental anomalies of the thoracic vasculature, suspected thoracic aortic dissection, aortic pathology, peripheral arterial vascular disease, aneurysm of the thoracic aorta or thoracoabdominal aneurysm, and trauma. Chest CT and chest CTA are considered not medically necessary for screening of asymptomatic patients, except for indications outlined in the Screening for Lung Cancer Using Computed Tomography (CT) Scanning medical policy.

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What to do

Action · 7 steps
01Billing team: For suspected pulmonary embolism, support the CT or CTA with clinical assessment and pre-test probability testing using the modified Wells criteria, because these are required to support the use of a CT pulmonary angiogram to diagnose suspected pulmonary embolism.
02Patients with a modified Wells score greater than 4 are considered high likelihood, and patients with a score of 4 or less are considered low likelihood.
03Billing team: Confirm that the facility billing the technical component of the CT is accredited in CT by the Intersocietal Accreditation Commission (IAC) or the American College of Radiology (ACR) CT module, because the professional component is reimbursed based upon the accreditation of the facility.
04Billing team: Note that the ACR and IAC facility accreditations require that interpreting professional physicians also be accredited.
05Billing team: Do not bill chest CT or CTA for screening of asymptomatic patients, which is considered not medically necessary.
06Billing team: CPT 71250, 71260, 71270 and 76380 are covered CT codes, and CPT 71275 and 75635 are covered CTA codes, and these are medically necessary only when performed according to the policy section.
07Consequence: BCBSMS makes no payment for services, treatments, procedures or supplies that are not documented to be medically necessary.

Codes mentioned

712507126071270763807127575635

Original notice

Computed Tomography (CAT Scan) and Computed Tomographic Angiography (CTA) of the Chest and Thorax
bcbsms.com · Always check the source before changing claims.
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