Lung-RADS is a quality assurance tool designed to standardize lung cancer screening CT reporting and management recommendations, reduce confusion in lung cancer screening CT interpretations, and facilitate outcome monitoring. Each exam should be coded 0-4 based on the nodule with the highest degree of suspicion. A negative screen is defined as categories 1 and 2; a positive screen is defined as categories 3 and 4. A negative screen does not mean that an individual does not have lung cancer. Lung-RADS 0 with 1-3 month follow-up LDCT may be recommended for pulmonary findings suggesting an indeterminate infectious or inflammatory process. Such findings may include segmental or lobar consolidation, multiple new nodules (more than six), large solid nodules (≥ 8 mm) appearing in a short interval, and new nodules in certain clinical contexts (e.g. immunocompromised patient). At 1-3 month follow-up, a new Lung-RADS classification and management recommendation should be provided based on the most suspicious nodule. New solid or part solid nodules with imaging features more concerning for malignancy than an infectious or inflammatory process meeting Lung-RADS 4B size criteria may be classified as such with appropriate diagnostic and/or clinical evaluation. Some findings indicative of an infectious or infectious process may not warrant short-term follow-up (e.g. tree-in-bud nodules or new < 3 cm ground glass nodules). These nodules may be evaluated using existing size criteria with a Lung-RADS classification and management recommendation based on the most suspicious finding. Endotracheal or endobronchial abnormalities that are segmental or more proximal are classified as Lung-RADS 4A. Subsegmental and/or multiple tubular endobronchial abnormalities favor an infectious process; if no underlying obstructive nodule is identified, these lesions may be classified as Lung-RADS 0 (likely infectious or inflammatory) or 2 (benign). The presence of air in segmental or more proximal airway abnormalities often favors secretions; if no underlying soft tissue nodule is identified, these findings may be classified as Lung-RADS 2. Segmental or more proximal airway nodules that persist on 3-month follow-up CT are upgraded to Lung-RADS 4B with management recommendation for further clinical evaluation (typically bronchoscopy).