Preface to the Imaging Guidelines

This policy covers eviCore Healthcare’s evidence‑based clinical decision support for advanced imaging and related procedures (CT, MRI, PET, radiation oncology, sleep studies, and cardiac/spine interventions) for common symptoms and symptom complexes and specific indications such as lung, thyroid, liver, pancreatic and renal lesion follow‑up, high‑risk breast MRI, BI‑RADS 3 follow‑up, cardiac repeat testing, and oncology surveillance. Coverage requires documentation of the patient’s clinical presentation and a recent clinical evaluation (generally within 60 days; spine/musculoskeletal x‑rays from episode onset/change are acceptable), advanced imaging should follow clinician evaluation (telephone/e‑contact may substitute), atypical or investigational requests and clinical trial imaging require physician review, and payer/CMS policies may supersede these guidelines.

"Renal failure and allergies to iodinated CT contrast"