Pediatric Cardiac Imaging Guidelines

This policy covers pediatric cardiac imaging modalities—including echocardiography, cardiac MRI, CT/CCTA and associated MRI/MRA procedures—for patients <18 years to evaluate common pediatric cardiac symptoms and conditions such as congenital heart disease, heart murmur, chest pain, syncope, Kawasaki disease, and pediatric pulmonary hypertension. Advanced imaging generally requires a recent (≤60 days) face‑to‑face evaluation, anesthesia is commonly required for infants and young children (typically <7 years), MRI should be performed both without and with gadolinium unless contraindicated, repeat or screening studies are not supported without evidence of progression or documented impact on management, and atypical presentations require physician review.

"Pediatric cardiac imaging (policy titled: Pediatric Cardiac Imaging Policy)"

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