Pediatric Cardiac Imaging Guidelines

Covers advanced pediatric cardiac imaging — including echocardiography, cardiac MRI (e.g., CPT 75557–75563, 76498), cardiac CT/CCTA (e.g., CPT 75572–75574) and related CT/CTA studies — for patients <18 with indications such as congenital heart disease, heart murmur, chest pain, syncope, Kawasaki disease, pediatric pulmonary hypertension and other specified pediatric cardiac indications. Major requirements/limitations: a recent (≤60 days) face‑to‑face clinical evaluation is required before advanced imaging, anesthesia is typically needed for children <7 or those unable to cooperate, routine asymptomatic screening is not supported unless specified, repeat studies require evidence of progression or impact on management, certain nuclear CPT codes are not used in pediatrics, and gadolinium must be avoided when contraindicated.

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