Pediatric Peripheral Vascular Disease (PVD) Imaging Guidelines

This policy covers pediatric peripheral vascular disease imaging (MRA, CTA, PET, duplex and noninvasive physiologic studies) for evaluation of PVD-related symptoms and conditions in patients under 18, including vascular anomalies, vasculitis, and disorders of the aorta and visceral arteries. Advanced imaging is limited to patients with documented active clinical signs/symptoms and generally requires a recent (within 60 days) face‑to‑face evaluation; routine screening of asymptomatic children or repeat studies without evidence of progression or documented impact on management is not supported, and special considerations include minimizing gadolinium exposure (use non‑contrast if contraindicated), anesthesia planning for young/developmentally delayed children, and adherence to section‑specific exceptions.

"CT and CTA have associated radiation risks."

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