Peripheral Nerve Disorders (PND) Imaging Guidelines

This policy covers advanced imaging for peripheral nerve disorders — including ultrasound, MRI/MRN, CT and nuclear imaging — for evaluation of focal neuropathies (e.g., carpal tunnel, ulnar, radial), polyneuropathy, brachial and lumbosacral plexus disorders, neuromuscular and muscle disorders, and peripheral nerve sheath tumors. Major requirements and limitations include a documented pertinent clinical evaluation by an established provider since symptom onset or change, appropriate laboratory and prior non‑advanced imaging, and EMG/NCV when indicated (case‑by‑case or pandemic exceptions apply); ultrasound is preferred for superficial nerves, MRI/MRN for deep or surgically relevant nerves, CT is limited to MRI contraindications, and atypical presentations require physician review.

"Nerve conduction studies (NCV) / EMG are often normal early in the disease course; this timing (one to four weeks after symptom onset) will be taken into consideration on a case by case basis regar..."