Neck Imaging Guidelines

This policy covers advanced neck imaging (CT, MRI, and nuclear medicine) for evaluation of common neck symptoms and syndromes including cerebrovascular/carotid disease, dysphagia/esophageal disorders, cervical lymphadenopathy and masses, head and neck malignancies, thyroid/parathyroid and salivary gland disorders, tracheal/bronchial disease, recurrent laryngeal palsy, neck pain, sore throat/hoarseness, and related presentations. Advanced imaging generally requires a pertinent clinical evaluation and basic prior testing (history, exam, labs, plain radiography or ultrasound), atypical presentations require physician review, MRI is not routinely first-line without prior CT/US findings, and contrast should be used selectively due to radiation, diagnostic interference (e.g., salivary stones, radioactive iodine studies), and other limitations.

"Imaging requests for individuals with atypical symptoms or clinical presentations that are not specifically addressed will require physician review (implying need for additional documentation/physi..."