Low-Dose CT of the Chest for Smoking History Guideline

Coding and Eligibility

The American College of Radiology indicates that Z87.891 is the appropriate code to use when ordering a low-dose CT scan for lung cancer screening in patients with significant smoking history 1
The primary risk factor that qualifies patients for lung cancer screening with LDCT is a personal history of tobacco use, which is indicated by code Z87.891 2
The U.S. Preventative Services Task Force recommends annual lung cancer screening with LDCT for individuals aged 55-80 years with ≥30 pack-year smoking history who currently smoke or have quit within the past 15 years 2, 1
The 2021 USPSTF update expanded eligibility to include individuals aged 50-80 years with ≥20 pack-year smoking history who currently smoke or have quit within the past 15 years 1

The American College of Radiology recommends that screening should use a low-dose CT multidetector scanner with parameters that limit radiation exposure 1
Typical parameters for LDCT include: 120-140 kVp, 20-60 mAs, average effective dose of 1.5 mSv or less 1
The technique should keep radiation dose as low as reasonably achievable while maintaining diagnostic quality 2

Documentation should include patient's age, smoking history in pack-years, current smoking status or years since quitting, and absence of symptoms suggestive of lung cancer 1