Pediatric Neck Imaging Guidelines

This policy covers pediatric neck imaging, including advanced cross-sectional and vascular modalities (MRI/MRA with or without contrast, CT, CT/MR angiography, MRI of orbit/face/TMJ, and associated CPT/unspecified procedures) for evaluation of neck pathology. It applies to patients ≤18 years for conditions such as neck masses, cervical lymphadenopathy, torticollis/dystonia, dysphagia, thyroid/parathyroid, tracheal and esophageal disease, etc., and requires documented active clinical signs/symptoms and a pertinent clinical evaluation (history/physical/labs); imaging for asymptomatic screening is not supported, atypical presentations need physician review, and repeat studies are limited unless progression or management impact is documented.

"CT Maxillofacial without contrast (includes sinuses, jaw, and mandible)"

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