Pediatric Head Imaging Guidelines

This policy covers pediatric head imaging (CT, MRI, nuclear medicine and related modalities) for patients under 18 with common presentations such as headache, head and face trauma, seizures/epilepsy, pediatric stroke, hydrocephalus/macro‑ or microcephaly, craniosynostosis, sinus and ear disorders, brain lesions, vascular malformations and other neurologic or skull‑base conditions. Major limitations/requirements: advanced imaging generally requires a prior pertinent clinical evaluation (history, physical including a detailed neurologic exam) and basic studies unless exceptions apply, is not supported for asymptomatic screening, repeat studies require evidence of progression or documentation that imaging will affect management, and atypical or unclear presentations need physician/specialist review.

"This tool addresses common symptoms and symptom complexes."

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