Pediatric Cardiac Imaging Guidelines

This policy covers pediatric cardiac imaging modalities—including echocardiography, cardiac MRI, CT/CCTA and cardiac catheterization—for evaluation and follow‑up of congenital and acquired pediatric heart disease and common presentations (e.g., murmurs, chest pain, syncope, Kawasaki disease, pulmonary hypertension) in patients <18. Major limitations/requirements: use the age‑based imaging pathway (<18 per Pediatric Cardiac Imaging Guidelines, ≥18 per adult guidelines), require a recent (within 60 days) face‑to‑face evaluation prior to advanced imaging except for guideline‑supported scheduled follow‑up, do not support routine screening of asymptomatic patients, atypical presentations need physician review, and anesthesia is often required for young children (typically <7 years).

"This tool addresses common symptoms and symptom complexes."

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