decisionhealth Newsletters, Answer Books - 2008 Issue 7 (July)
National_Coverage_Determinations_Manual / Computed Tomography 220.1
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Article Overview
This Medicare coverage article explains the National Coverage Determinations Manual entry for computed tomography and related imaging services. It is relevant to providers, radiology practices, hospital billing teams, and compliance staff who need to understand the scope of coverage guidance, equipment and setting requirements, and the status of coverage for associated imaging methods. The article also identifies the governing CMS framework and references the broader process used when national coverage is not established for a service.
Why This Topic Matters
It helps readers identify whether the page applies to CT-related billing, coverage review, facility compliance, and Medicare medical necessity documentation. It also provides context for how CMS treats certain CT-related imaging services and when local contractor review is used instead of a national determination.
Article Sections
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A. General
Introduces the overall Medicare coverage framework for computed tomography and the broad conditions that apply to covered examinations.
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B. Determining Whether a CT Scan Is Reasonable and Necessary
Discusses the documentation and review considerations used to assess whether a CT service is appropriate for a patient and claim.
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C. Approved Models of CT Equipment
Describes the equipment approval framework and the types of evidence used to establish that a CT model meets program requirements.
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D. Mobile CT Equipment
Covers Medicare and safety considerations for CT services furnished on mobile units, including hospital and ambulatory settings and related claims review.
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E. Multi-Planar Diagnostic Imaging (MPDI)
Explains the imaging technique addressed in the article and its relationship to covered CT scanning services.
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F. Computed Tomographic Angiography (CTA)
Summarizes the article’s discussion of CTA and the national coverage status noted by CMS.
What You Will Learn
- How Medicare frames coverage for CT services in general
- What the article says about medical necessity review for CT claims
- What kinds of CT equipment approval information are referenced
- How mobile CT services are addressed in different care settings
- How the article treats related CT imaging methods and coverage status
Who Should Read This
- Radiology coders
- Medical billers
- Hospital compliance staff
- Physician practice administrators
- Medicare coverage analysts
- Radiology department managers
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