Description of Procedure or Service

This policy addresses whole-body computed tomography (CT) scanning or whole-body CT screenings as a potential preventive measure for individuals who have no signs or symptoms of disease.

Whole body CT scans, encompassing the body from the neck to the pelvis have been proposed as a general screening test for diseases of the thyroid (i.e., cancer), lungs (i.e., lung cancer), heart (i.e., cardiovascular disease), and abdominal and pelvic organs (cancer, cardiovascular disease). Often the test is marketed directly to the patient and is offered through mobile CT scanners that travel from community to community.

Related Policy

Computed Tomography to Detect Coronary Artery Calcification

***Note: This Medical Policy is complex and technical. For questions concerning the technical language and/or specific clinical indications for its use, please consult your physician.

Policy

Whole body computed tomography scan as a screening test is considered investigational. BCBSNC does not provide coverage for investigational services or procedures.

Benefits Application

This medical policy relates only to the services or supplies described herein. Please refer to the Member's Benefit Booklet for availability of benefits. Member's benefits may vary according to benefit design; therefore, member benefit language should be reviewed before applying the terms of this medical policy. 

When whole body computed tomography scan as a screening test is covered

Not applicable. 

When whole body computed tomography scan as a screening test is not covered

Whole body CT scanning for screening is considered investigational for all applications.

Policy Guidelines

The American College of Radiology (ACR) published the following statement regarding whole body CT scanning: "The ACR, at this time, does not believe there is sufficient evidence to justify recommending total body CT screening for patients with no symptoms or a family history suggesting disease. To date, there is no evidence that total body CT screening is cost efficient or effective in prolonging life. In addition, the ACR is concerned that this procedure will lead to the discovery of numerous findings that will not ultimately affect patients’ health but will result in unnecessary follow-up examinations and treatments and significant wasted expense."

The American Association of Physicists in Medicine (AAPM) issued a Policy on CT Whole Body Screening (PS 9-A) AAPM noted that "The use of computed tomography (CT) for total body screening of asymptomatic patients has not been found to be scientifically justifiable or clinically efficacious." AAPM concerns included that "the procedure may lead to the discovery of minor anomalies that have no influence on patient health, and that their identification can lead to added medical examinations with associated risks and increased healthcare costs, (2) professional medical organizations have not established clinical guidelines for appropriate use of total body CT screening due to the lack of scientific evidence demonstrating a health benefit, and (3) because of the lack of a demonstrated health benefit, the exposure to ionizing radiation is not justified."

Information from the U.S. Food and Drug Administration (FDA) indicates that recommendations from the U.S. Preventive Services Task Force and the American Medical Association have been added to those of the American College of Radiology, the American College of Cardiology/American Heart Association, the American Association of Physicists in Medicine, and the Health Physics Society, all of whom do not recommend CT screening. The FDA states that there is no data demonstrating that whole-body CT screening is effective in detecting any particular disease early enough to improve outcomes and emphasizes that any presumed benefit may not outweigh the potential harms, such as unnecessary radiation exposure and false positives.

Two retrospective reviews of findings/recommendations from 982 and 1,192 whole body CT screenings were published. Both studies observed a strong association between age of the patient and the number of findings and recommendations. Actionable findings ranged from 22.5% of subjects younger than 40 years of age to 80% of patients older than or equal to 80 years of age; follow-up imaging was the most common recommendation.

Obuchowski et al conducted a small (50 subjects) randomized trial of whole-body screening (vs. no screening for 3 years) to determine the feasibility of a larger scale study. Ninety percent of the subjects were reported to be compliant with follow-up at 2 years. Images were interpreted independently by 6 radiologists from 2 institutions. Based on one interpretation, 16 (64%) subjects in the screening group had abnormal findings, but no cancers were detected. A second interpretation showed a similar rate of abnormal findings, although abnormalities were not in the exact same group of 16 subjects. On average, medical costs were twice as high for screened subjects. The authors concluded that a full-scale randomized controlled trial of whole-body screening will need to account for the large variability in interpretation of the images, the high rate of incidental findings, and the low prevalence of cancers. Current literature does not support an improvement in health outcomes with whole body CT screening.

Billing/Coding/Physician Documentation Information

This policy may apply to the following codes. Inclusion of a code in this section does not guarantee that it will be reimbursed. For further information on reimbursement guidelines, please see Administrative Policies on the Blue Cross Blue Shield of North Carolina web site at www.bcbsnc.com. They are listed in the Category Search on the Medical Policy search page.

Applicable service codes: 76497

BCBSNC may request medical records for determination of medical necessity. When medical records are requested, letters of support and/or explanation are often useful, but are not sufficient documentation unless all specific information needed to make a medical necessity determination is included.

Scientific Background and Reference Sources

BCBSA Medical Policy Reference Manual [Electronic Version]. 6.01.41, 12/17/03

Specialty Matched Consultant Advisory Panel - 7/2004

American College of Radiology (2002, September). Statement on CT Screening Exams. Retrieved March 6, 2006 from http://www.acr.org/s_acr/doc.asp?TrackID=&SID=a&DID=16014&CID

ECRI Health Technology Forecast (2005, January 17). Computed tomography for whole-body screening. Retrieved March 6, 2006 from http://www.ta.ecri.org/Forecast/Prod/summary/detail.aspx?doc_id=5037

U.S. Food and Drug Administration (2005, October). Whole Body Scanning Using Computed Tomography. Retrieved March 6, 2006 from http://www.fda.gov/cdrh/ct

BCBSA Medical Policy Reference Manual [Electronic Version]. 6.01.41, 2/15/07

BCBSA Medical Policy Reference Manual [Electronic Version]. 6.01.41, 4/9/08

BCBSA Medical Policy Reference Manual [Electronic Version]. 6.01.41, 5/13/2010

American College of Radiology (ACR). ACR statement on whole body CT screening. [ACR Web site]. Original: 09/27/00. (Revised: 09/28/02). Available at: https://www.acr.org/Advocacy/Position-Statements/Whole-Body-CT-Screening. Retrieved October 29, 2025.

U.S. Food and Drug Administration. Full-Body CT Scans - What You Need to Know. Available at https://www.fda.gov/radiation-emitting-products/medical-x-ray-imaging/full-body-ct-scans-what-you-need-know (Content current as of 12/05/2017) Retrieved October 29, 2025

U.S. Food and Drug Administration (2005, October). Whole-Body CT Screening--Should I or shouldn't I get one? Available at https://www.fda.gov/radiation-emitting-products/medical-x-ray-imaging/whole-body-ct-screening-should-i-or-shouldnt-i-get-one (Content current as of 12/05/2017) Retrieved October 29, 2025,

Obuchowski NA, Holden D, Modic MT et al. Total-body screening: preliminary results of a pilot

randomized controlled trial. J Am Coll Radiol 2007; 4(9-Jan):604-11

Obuchowski N, Modic MT. Total body screening: predicting actionable findings. Acad Radio

2006; 13(4):480-5

Furtado CD, Aguirre DA, Sirlin CB et al. Whole-body CT screening: spectrum of findings and recommendations in 1192 patients. Radiology 2005; 237(2):385-94.

The American Association of Physicists in Medicine (AAPM) Policy on CT Whole Body Screening, Policy number PS 9-A. Retrieved October 29, 2025, from https://www.aapm.org/org/policies/details.asp?id=2553

Policy Implementation/Update Information

8/12/04 New policy issued. Specialty Matched Consultant Advisory Panel review 7/23/2004 with no submitted change or addition to original policy draft. References added. Notification 8/12/2004. Effective 10/14/2004.

6/5/06 Added rationale to Policy Guidelines section. Added policy number to Key Words. Updated references. Specialty Matched Consultant Advisory Panel review 5/3/2006 with no change to policy coverage criteria.

6/16/08 Specialty Matched Consultant Advisory Panel review 5/15/08. No change to policy statement. (adn)

6/22/10 Policy Number(s) removed (amw)

9/28/10 Description section revised. No change in policy statement. Policy status changed to “Active policy, no longer scheduled for routine literature review.”  (adn)

1/21/26 Policy titled “Whole Body Computed Tomography Scan as a Screening Test” reinstated. Policy statement updated: “Whole body computed tomography scan as a screening test is considered investigational. BCBSNC does not provide coverage for investigational services or procedures.” Description, Policy Guidelines and References updated. Related policies section added. Code 76497 added to Billing/Coding section. Specialty Matched Consultant Advisory Panel review 11/2025. Medical Director review 11/2025. Notification given 1/21/26 for effective date 4/1/26. (tm)