Head Imaging Guidelines

This policy covers head imaging (CT, MRI and related anatomic studies) for evaluation of common head-related symptoms and diagnoses, including headache, seizures/epilepsy, head trauma/stroke/TIA, dementia, multiple sclerosis and other demyelinating diseases, aneurysm/AVM, CNS infection, movement and behavioral disorders, cranial neuropathies (e.g., facial palsy), and many other listed indications. Major limitations: atypical presentations not specifically addressed require physician review and additional documentation; advanced imaging generally requires a clinical evaluation within 60 days; duplicate studies of the same anatomic region/modality are not routinely covered; MRI is preferred with specified sequencing/contrast restrictions and specific coding/usage rules for pituitary, IAC, TMJ, maxillofacial and follow-up studies.

"Fluctuating hearing loss."

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