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Medical Policy

Radiology Section

Policy Name Policy ID Number Date Modified
Computed Tomography to Detect Coronary Artery Calcifications RAD06 02/01/2024
Cone Beam Computed Tomography of the Breast RAD59 03/01/2024
Magnetic Resonance Spectroscopy RAD27 10/01/2023
Opto-acoustic Imaging of the Breast RAD60 01/01/2024
Positional Magnetic Resonance Imaging (MRI) RAD49 04/01/2024

Screening for Vertebral Fracture Using Dual X-ray Absorptiometry (DXA)

Policy Version Effective 9/1/2024:
Screening for Vertebral Fracture or Fracture Risk with Dual X-ray Absorptiometry (DXA)

RAD48 06/01/2024
Thermography RAD17


Ultrasonographic Measurement of Carotid Artery Intima-Media Thickness as an Assessment of Atherosclerosis RAD37 02/01/2024
Whole Body CT Screening RAD40 11/01/2023
Whole Body Dual X-ray Absorptiometry (DXA) to Determine Body Composition RAD41 09/01/2023

Wireless Capsule Endoscopy for Gastrointestinal (GI) Disorders

RAD38 04/01/2024