Abdomen Imaging Guidelines

This policy covers advanced abdominal imaging—primarily CT and MR studies of the abdomen and abdomen/pelvis (including CT enterography and MRCP as appropriate)—for a wide range of indications such as abdominal pain, suspected abscess/sepsis, renal/ureteral stones, mesenteric/colonic ischemia, post‑operative pain, hernias, abdominal masses, aneurysms, trauma, and metabolic liver disorders. Major requirements/limitations include a clinical evaluation within 60 days (telephone/e‑contact acceptable for established patients), prior non‑advanced imaging and laboratory evaluation and specialist consultation when indicated, routine use of IV contrast unless contraindicated (renal insufficiency/allergy → non‑contrast CT), defined imaging extents (diaphragm to umbilicus; iliac crest to pubis for pelvis), atypical presentations requiring physician review, CT enterography oral contrast ingestion, and verification for any 3D rendering requests.

"This tool addresses common symptoms and symptom complexes."