Preface to the Imaging Guidelines

This policy provides eviCore’s evidence‑based clinical guidelines for advanced diagnostic imaging and procedures—including nuclear medicine, ultrasound, CT, MRI, PET, radiation oncology, sleep studies, gastrointestinal endoscopy, and cardiac, musculoskeletal and spine interventions—applied to common symptom complexes and patient populations such as general, cardiac, oncologic, spine and musculoskeletal conditions. Major limitations/requirements: atypical or unaddressed presentations require physician review; adequate clinical information and often a prior clinical (sometimes face‑to‑face) evaluation are required to establish medical necessity; coverage is subject to health plan benefits, applicable state/federal laws, and these proprietary guidelines are intended to guide but not replace clinician judgment.

"This tool addresses common symptoms and symptom complexes."