Head Imaging Guidelines

eviCore approves modality‑specific advanced head imaging (MRI, CT, CTA/MRA, PET/SPECT, cisternography) for defined neurologic indications (e.g., seizures, cranial neuropathies, dementia/NPH, Chiari, trauma, infection, vascular/movement disorders) but excludes routine imaging for primary headache without red flags, considers amyloid PET and many non‑FDG PETs not medically necessary or NCD‑limited, and deems 3D hippocampal/temporal lobe volumetrics not medically necessary. Coverage generally requires a prior pertinent clinical evaluation (detailed history, neurologic exam and appropriate labs — telehealth acceptable), plus indication‑specific documentation (e.g., 6 months documented cognitive decline or qualifying bedside/neuropsych testing for dementia PET, failed medical therapy for trigeminal neuralgia, red‑flag features for facial palsy, and specialist or pre‑surgical justification for advanced functional studies), with MRI preferred to CT except in specified urgent or MRI‑contraindicated situations.