Head Imaging Guidelines
EVICORE-HEAD
These guidelines approve modality‑specific head and neck imaging (CT, MRI, CTA/MRA, angiography, PET/SPECT) for defined neurologic indications (stroke/TIA, seizures, trauma, aneurysms/AVMs, infection, movement disorders, hydrocephalus, cranial neuropathies, etc.) but identify numerous investigational or non‑covered procedures (e.g., volumetric 3D hippocampal analysis/NeuroQuant, amyloid PET outside Medicare CED, PET perfusion CPT 78609, and most FDG PET uses not meeting the Medicare NCD). Key requirements include a pertinent clinical evaluation with a detailed history and neurological exam prior to advanced imaging (specified exceptions apply), condition‑specific prior testing/documentation (eg structural imaging, labs, neurocognitive testing for dementia), adherence to modality‑specific intervals/limitations, and Medicare CED enrollment for amyloid PET.
"Repeat MRI Spine imaging is not indicated for patients with normal initial spine imaging unless there are new or worsening signs or symptoms from baseline that suggest spinal cord pathology (Chiari..."