Neck Imaging Guidelines

This policy covers advanced neck imaging (primarily CT and MRI diagnostic strategies) for evaluating a wide range of neck conditions and symptom complexes including cerebrovascular/carotid disease, dysphagia and esophageal disorders, cervical lymphadenopathy and neck masses, malignancies, thyroid/parathyroid and salivary gland disorders, tracheal/bronchial pathology, neck pain, hoarseness, and related presentations. Advanced imaging requires a current (≤60 days) clinical evaluation with relevant history/physical, labs and prior non‑advanced imaging (plain x‑ray or ultrasound), atypical presentations need physician review, CT is generally performed with contrast (non‑contrast or “without-and-with” protocols are discouraged and contrast is avoided in specific situations such as tracheal evaluation or when planning radioactive iodine studies), and MRI is reserved for select indications or when CT/ultrasound suggest further characterization.

"A current clinical evaluation (within 60 days), which includes a relevant history and physical examination and appropriate laboratory studies and non-advanced imaging modalities, such as plain x-ra..."