Chest x-rays generate images of the heart, lungs, airways, blood vessels, spinal column, and bones. These images can be used to diagnose illness, confirm suspected health conditions, monitor treatment progress, and much more. This imaging technique is commonly used in healthcare settings, including both inpatient hospital stays and outpatient clinics. Medicare generally provides coverage for chest x-rays as long as they are deemed medically necessary to diagnose, monitor, or treat an illness or condition.
How Does a Chest X-ray Work?
X-rays utilize electromagnetic radiation that is directed through the body. When the rays come in contact with soft tissues, such as skin and organs, the tissues cannot absorb the radiation and it passes through unimpeded. This shows up as dark areas on the x-ray image. Denser body parts, such as bones and heart muscles, can absorb the radiation, and they show up white on the x-ray.
These scans require no special preparation beforehand. Unlike MRIs, chest x-rays are still safe for patients with metal implants in their bodies, such as pacemakers or artificial heart valves. A lead apron will be draped over the patient’s genitals to protect them from the potentially-harmful effects of radiation, mainly infertility.
Images will be taken from both the front and side views of the chest. While the images are being recorded, you will need to hold your breath to prevent the images from being blurry and difficult to read. The radiation used during an x-ray is quite safe and is not associated with any major health issues, especially given the small amount utilized in an x-ray. However, x-rays are often contraindicated for women who are pregnant as the unborn fetus is at higher risk for injury from exposure.
Why is an X-ray Done?
Due to the ability of x-rays to visualize the internal structures and organs in the body, x-rays can be used to diagnose diseases, spot abnormalities in the bones and other tissues, note fluid or air in or around the lungs, examine the extent of damage after chest trauma has occurred, and much more.
For diagnostic purposes, chest x-rays may be done if you are experiencing chest pain, shortness of breath, a fever, or a persistent cough. If these symptoms occur, the x-ray can help in the diagnosis of broken ribs or other bones, heart failure, pneumonia, cancers, emphysema, or air being present in the space outside the lungs.
Chest x-rays can also be used to visualize the heart, assessing its shape and size. If abnormalities are visible, it can indicate heart issues that may require additional testing to diagnose potential problems and keep them from worsening.
Medicare Benefits for Chest X-rays
X-rays may be covered under Medicare Part B, which covers many outpatient diagnostic tests, treatments, preventative measures, physician visits, and more. In order to qualify for coverage, the x-ray must be deemed medically necessary by your provider. Medically necessary x-rays are those required for diagnostic purposes or as part of a treatment plan.
The x-ray must also be performed at a Medicare-approved facility that accepts Medicare insurance. For Original Medicare plans, Part B provides coverage for services at 80 percent, meaning that the other 20 percent of the Medicare-approved amount must be paid for out of pocket by the patient. This 20 percent is in addition to any premium payments, copayments, and out-of-pocket costs to reach your annual deductible. If you are dual-eligible or have a Medigap plan, you may have help paying for coinsurance or copayments.
If you have a Medicare Part C, or Medicare Advantage, plan, you will also receive coverage for x-rays. These are funded by private insurance companies and often provide additional benefits in addition to the Part A and Part B benefits offered by Original Medicare.