Pediatric Musculoskeletal Imaging Guidelines

This policy covers pediatric musculoskeletal imaging—plain radiography and advanced modalities (MRI, CT and select nuclear studies)—for a wide range of pediatric indications including fractures/dislocations, soft‑tissue and bone masses, limping, developmental dysplasia of the hip, AVN/Perthes, suspected child abuse, infection/osteomyelitis, tendon/muscle injuries, SCFE, limb‑length discrepancy, congenital foot anomalies, and related conditions. It applies to patients <18 years (adult rules for ≥18), requires a face‑to‑face evaluation within 60 days and prior plain x‑rays before advanced imaging, mandates physician review for atypical presentations, notes limited/rare use of certain contrast and pediatric nuclear CPTs, and restricts repeat or advanced imaging unless results will change patient management.

"PEDMS-16-CONGENITAL ANOMALIES OF THE FOOT"

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