Preface to the Imaging Guidelines

eviCore supports medically necessary advanced imaging (US, CT, MRI, PET/CT, selected 3D rendering and limited whole‑body imaging for specific oncologic or genetic indications) but excludes routine whole‑body CT screening, routine PET‑MRI, investigational quantitative mp‑MRI analyses (Category III codes), and generally disallows WBMRI except for select cancer predisposition or autoimmune conditions, with CMS/Medicare policies taking precedence. Key requirements: submit a recent clinical evaluation, history/physical, prior imaging/labs and any condition‑specific documentation to establish medical necessity (3D rendering needs documented physician supervision; PET‑MRI is allowed only if PET‑CT criteria are met and PET‑CT is unavailable), and adhere to modality‑specific contrast, contraindication, coding, and prior‑authorization limits.

"Indications for ultrasound may include, but are not limited to: Brain and spine imaging when not obscured by dense bony structures."