Head Imaging Guidelines

This policy governs head imaging studies—including CT and MRI of the head, orbits, internal auditory canals, pituitary and temporal bones—used to evaluate neurological symptoms and conditions such as headache, seizures/epilepsy, head trauma, stroke/TIA, dementia, MS and other demyelinating disorders, CNS infection, aneurysm/AVM, pituitary lesions, facial palsy and related cranial disorders. Major limitations require avoidance of redundant same‑modality studies, a recent clinical evaluation with a neurologic exam (generally within 60 days) before advanced imaging, often an initial CT before MRI for specified indications, restrictions on contrast MRI (usually only for short‑interval follow‑up of a prior non‑contrast study), and single‑study rules/billing constraints for pituitary and IAC imaging.

"For 'Screening for metallic fragments before MRI' — documentation that a plain x-ray was performed as the initial screening test for metallic fragments prior to MRI"