Appendix E - National Coverage Determinations Manual / Computed Tomography 220.1

Why This Topic Matters

CT coverage policy affects whether claims are payable and what documentation and operational considerations apply for different scanning settings and service types. Understanding the manual helps organizations align imaging services with Medicare’s coverage framework and related administrative requirements.

Article Sections

1. A. General

   Introduces the overall Medicare coverage framework for CT scans and the broad conditions under which coverage is considered. It also describes the general role of CT in diagnostic evaluation.

2. B. Determining Whether a CT Scan Is Reasonable and Necessary

   Discusses the information needed to support coverage review and the general factors considered when assessing medical appropriateness. It also addresses claim review concerns related to utilization and documentation.

3. C. Approved Models of CT Equipment

   Outlines the criteria and documentation used to determine whether CT equipment models are acceptable for covered services. This section also covers how manufacturers may establish approval evidence.

4. D. Mobile CT Equipment

   Describes coverage and operational considerations for CT services furnished on mobile units. It addresses hospital and ambulatory settings, billing, and claims review issues.

5. E. Multi-Planar Diagnostic Imaging (MPDI)

   Explains the imaging technique referenced in connection with CT scanning and how Medicare treats it when furnished with a covered CT service.

6. F. Computed Tomographic Angiography (CTA)

   Summarizes the discussion of CTA as a CT-based vascular imaging service and notes the article’s description of Medicare coverage status and review approach.