Chest CT scan (without contrast)

A chest CT without contrast is the scan for looking at lung tissue itself: nodules, scarring, airway disease, air where it should not be. Lung is mostly air, so it stands out against everything around it without any dye being injected.

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What it is

The lungs are the one place in the body where contrast is usually unnecessary. They are full of air, and air against tissue is already the strongest contrast an X-ray beam can encounter, so the fine architecture of the lung, its nodules, its scarring, its airways, is visible on a plain scan. This code is that plain scan. It is the standard way of chasing something seen on a chest X-ray, of characterizing a nodule, and of following interstitial lung disease over time. What it does not do well is separate a mass from the blood vessels and lymph nodes packed around the heart, which is where injected dye starts to matter.

Why it is done

  • To take a closer look at an abnormality spotted on a chest X-ray
  • To find or follow a lung nodule, including measuring whether it has grown between scans
  • To investigate a cough, breathlessness or chest pain when the lungs themselves are the suspected source
  • To assess interstitial lung disease, bronchiectasis, emphysema or the lasting effects of infection, where the pattern in the lung tissue is the diagnosis

What to expect

Patients lie on their back with arms raised above the head and are asked to hold a breath for the few seconds the table moves through the scanner. There is no injection and no fasting. The appointment is short, usually well under half an hour door to door. Dose is adjusted to body size and to the question, and screening protocols in particular use a much lower dose than a diagnostic study. A radiologist reads the images afterward and sends a report.

Questions worth asking

  • Is this being ordered as lung cancer screening? Screening has its own code and its own coverage rules, and is priced differently from a diagnostic chest CT.
  • Was contrast considered and deliberately left out? Repeating the scan with contrast later means paying for two studies instead of one.
  • What is the facility fee here compared with a freestanding imaging center for the same scan?
  • If this is a follow-up to watch a nodule, how many repeat scans are expected over the next couple of years, and at what interval?

What Chest CT scan (without contrast) costs by state

Chest CT scan (without contrast) prices at hospitals

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