Diagnosis: Nonspecific abnormal finding of lung field
Treatment: CT (computed tomography) of Chest Without Contrast
The insurer denied: CT (computed tomography) of Chest Without Contrast
The denial is overturned.

The patient is an adult female with a 60-pack-year history of smoking. A baseline lung cancer screening chest CT (computed tomography) 2 years ago demonstrated calcified lung granulomas and two 2-mm (millimeter) and a 3-mm (millimeter) nodule in the right lower lobe and 3 mm ((millimeter) and 2 mm (millimeter) nodules in the left upper lobe for which a 12 month follow up CT (computed tomography) was recommended as a Lung-RADS (Lung Imaging Reporting and Data System) Category 2, benign findings. A chest CT (computed tomography) performed last year demonstrated calcified lung granulomas and stable 3-5 mm (millimeter) nodules in the right lower lobe and a stable 3 mm (millimeter) nodule in the left upper lobe for which a 12 month follow up CT (computed tomography) was recommended. The request is for coverage of last years' CT (computed tomography) chest.

The CT (computed tomography) of the chest without contrast (dye) was medically necessary.

The patient has a 60-pack-year history of smoking. A baseline lung cancer screening chest CT (computed tomography) of 2 years ago demonstrated calcified lung granulomas and two 2 mm (millimeter) and a 3 mm (millimeter) nodule in the right lower lobe and 3 mm (millimeter) and 2 mm (millimeter) nodules in the left upper lobe for which a 12 month follow up CT (computed tomography) was recommended as a Lung-RADS (Lung Imaging Reporting and Data System) Category 2, benign findings. As this patient already qualified for lung cancer screening, the recommended CT (computed tomography) chest imaging is at yearly intervals for Category 2 benign findings. The requested chest CT (computed tomography) of last year was medically necessary per USPSTF (United States Preventive Services Task Force) and CDC (Center for Disease Control and Prevention) national guidelines.