Head Imaging Guidelines

eviCore favors MRI for most head/neck indications, supports CT for trauma/hemorrhage/bony or emergent evaluation, endorses CTA/MRA for vascular concerns, and treats many advanced techniques as investigational or limited (e.g., amyloid PET only under CMS CED, volumetric 3D hippocampal analysis and most PET perfusion studies noncovered); advanced imaging is not indicated for uncomplicated primary headache without focal deficits or red flags. Authorization requires a documented pertinent clinical evaluation with detailed history and neurological exam (specified exceptions), relevant labs/prior imaging and specialist findings, and compliance with NCD/CED and modality-specific rules (e.g., dementia must show ≥6 months decline or abnormal bedside testing for PET/structural imaging; MRI with contrast 70552 is limited to follow-up of a very recent non‑contrast MRI within two weeks).

"A pertinent clinical evaluation including a detailed history, physical examination including a neurological examination and appropriate laboratory studies prior to advanced imaging (telehealth eval..."