Pediatric Neck Imaging Guidelines

This policy covers pediatric neck imaging (CT, MRI/MRA and related procedures) for evaluation of pediatric neck symptoms and symptom complexes addressed by the clinical decision support tool, including neck masses, cervical lymphadenopathy, dystonia/torticollis, dysphagia, thyroid/parathyroid, tracheal and esophageal conditions. It applies to patients <18 years under the Pediatric Neck Imaging Guidelines (patients ≥18 follow Adult Neck Imaging Guidelines) and is intended for common symptom presentations specified in the tool. Major requirements/limitations: atypical presentations require physician review/authorization, a recent (within 60 days) face‑to‑face evaluation is expected before advanced imaging, routine asymptomatic screening is not supported, repeat studies require evidence they will affect management, gadolinium use is limited/contraindicated in some patients, and MRI in young children often requires anesthesia.

"Imaging for pediatric neck symptoms and symptom complexes addressed by this clinical decision support tool (common presentations)."