Oncology Imaging Guidelines

This policy covers evidence‑based guidance for ordering advanced and conventional imaging (CT, MRI, PET and modality‑specific studies) for diagnosis, staging, surveillance, and treatment monitoring of suspected or confirmed malignancies across major tumor types (e.g., CNS, head & neck, thoracic, breast, GI, GU, skin, sarcoma, neuroendocrine). Key requirements and limitations include a recent clinical evaluation within 60 days (except guideline‑supported surveillance/screening), histologic confirmation and documented staging unless otherwise specified, routine avoidance of advanced imaging in asymptomatic patients without signs of systemic disease, specified imaging frequency limits during therapy and surveillance, and physician review for atypical presentations; the guidance is proprietary to eviCore.

"This tool addresses common symptoms and symptom complexes."