Head Imaging Guidelines

EviCore covers modality‑appropriate CT, MRI, CTA/MRA, MRV/CTV and PET/SPECT for a broad set of neurologic indications (e.g., new/worsening cranial neuropathies, seizures, stroke/TIA, suspected vascular lesions, dementia workup, NPH, Chiari, facial palsy with red flags, tumor/trauma/infection surveillance), but restricts or excludes many uses (amyloid PET only for amyloid‑reducing therapy eligibility, FDG/non‑FDG perfusion PET largely noncovered for routine dementia/MCI, volumetric MRI generally not medically necessary, and multiple modality‑specific pregnancy/contrast and duplication limitations). Key requirements: advanced imaging generally requires a prior pertinent clinical evaluation (detailed history, neurological exam and labs) with indication‑specific documentation (specialist consultation or failed conservative therapy when required, red‑flag criteria, pre‑surgical/epilepsy protocols, NPH symptom criteria, and for amyloid therapy strict eligibility including age 50–85 and qualifying cognitive scores such as MMSE ≥22 and CDR 0.5–1.0).