Head Imaging Guidelines

Covers advanced head imaging (CT, MRI, CTA/MRA, FDG PET, SPECT) for specific clinical indications—trauma, headaches with red flags, seizures (including pre‑surgical localization), dementia (with strict FDG PET limits), aneurysm/AVM screening and surveillance, pituitary/orbit/skull disorders, MS, infection and related problems—while excluding routine imaging for primary or chronic headache without red flags and deeming many technologies investigational/noncovered (amyloid PET except under CED, 3D volumetrics, routine perfusion/DTI/fMRI/SPECT, PET perfusion). Key requirements: a recent (≤60 days) face‑to‑face evaluation with detailed history, neurological exam and appropriate labs (endocrine testing for pituitary) is required except for listed exceptions (specialist follow‑up, scheduled surveillance, select ENT/ophthalmic complaints), and many advanced/nonstandard studies require specialist consultation or Medical Director review and must comply with Medicare NCD/CED rules.