Pediatric Neck Imaging Guidelines

This policy covers pediatric advanced neck imaging — including CT, MRI (with/without gadolinium), MRA and related face/orbit/TMJ/maxillofacial studies and unlisted imaging for planning — for evaluation of neck pathology. It applies to children with active signs or symptoms (eg, neck masses, cervical lymphadenopathy, dystonia/torticollis, dysphagia, thyroid/parathyroid, tracheal or esophageal disease), requires a recent (within 60 days) face‑to‑face evaluation, prohibits routine asymptomatic screening, limits repeat studies to cases where progression or management will be affected, and includes anesthesia needs for young/developmentally delayed children and contraindications to gadolinium or MRI.

"This tool addresses common symptoms and symptom complexes."

Sign up to see full coverage criteria, indications, and limitations.