Oncology Imaging Guidelines

This policy covers oncology imaging services — including general imaging principles, nuclear medicine and PET, disease-specific protocols for primary CNS tumors and many solid tumors (e.g., non‑small cell lung cancer, esophageal/GE junction cancer), and procedures not otherwise listed. Coverage is limited to studies specified in disease‑specific sections for patients with the listed cancer diagnoses or predisposition syndromes; atypical presentations or requests not addressed require physician review, advanced imaging generally needs a recent clinical evaluation (within 60 days), repeat studies are restricted (e.g., not within 6 weeks), and imaging for malignancy/recurrence usually requires histologic confirmation unless otherwise noted.

"15 to 39 years old at initial diagnosis (Adolescent and Young Adult (AYA) oncology individuals): When unique guidelines for a specific cancer type exist only in either Oncology or Pediatric Oncolog..."