Computed tomography (CT) chest imaging for diagnosis of COVID-19 pneumonia



    Policy Impacted

    MA09.002m High-Technology Radiology Services



    Purpose

    The purpose of this News Article is to provide advance notice regarding the addition of CT Chest imaging for diagnosis of COVID-19 pneumonia.

    This News Article addressing computed tomography (CT) chest imaging for diagnosis of COVID-19 pneumonia is effective from March 6, 2020 through July 31, 2020 and is subject to re-evaluation for the duration of the public health emergency.



    Background

    There is currently an outbreak of respiratory disease caused by a novel coronavirus, a highly contagious viral pneumonia, which has now been detected nationally and internationally. The virus has been named “SARS-CoV-2” and the disease it causes has been named “Coronavirus Disease 2019” (COVID-19). To effectively respond to the COVID-19 outbreak, rapid detection of cases and contacts, appropriate clinical management and infection control, and implementation of community mitigation efforts are critical.

    The Centers for Disease Control and Prevention (CDC) discusses prevention and treatment of SARS-CoV-2 (Coronavirus Disease 2019 (COVID-19)) on their website at https://www.cdc.gov/coronavirus/2019-ncov/about/prevention-treatment.html.

    Coronavirus disease 2019 (COVID-19) is a highly contagious viral pneumonia. In the absence of a vaccine or other treatment, early and accurate diagnosis is essential to avoid further spread of the disease. While reverse transcription polymerase chain reaction (RT-PCR) testing is accurate and diagnostic in most cases, there is some evidence that computed tomography (CT) of the chest has greater sensitivity, especially in the early stages of disease. This greater sensitivity makes CT imaging of the chest a potentially important add-on diagnostic test when RT-PCR is negative or nondiagnostic.
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    Indications

    N/A



    Coverage Statement

    CT imaging of the chest is considered medically necessary for individuals under investigation, as defined by the Centers for Disease Control (CDC), for Coronavirus Disease 2019 (COVID-19) pneumonia when reverse transcription polymerase chain reaction (RT-PCR) is negative or cannot be performed.

    For the Company's plans that are subject to radiology utilization management through AIM Specialty Health® (AIM) for outpatient non-emergent diagnostic imaging services and certain high-technology radiology services, AIM will apply the above coverage criteria to determine the medical necessity for these services. To view AIM’s current and future guidelines, go to the Resources section of AIM’s website, available at https://aimspecialtyhealth.com/resources/clinical-guidelines/radiology/



    Dosing and Administration

    N/A



    Black Box Warnings and/or Contraindications

    N/A



    Coding

    CPT Codes

    71250, 71260, 71270








    Issued on - 05/08/2020

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