Pediatric and Special Populations Oncology Imaging Guidelines

Covers diagnostic and advanced imaging (CT, MRI, PET and conventional imaging) for pediatric and special‑population oncology patients, with disease‑specific guidance across a wide range of childhood malignancies and cancer predisposition syndromes (e.g., leukemias, CNS tumors, lymphomas, neuroblastoma, renal and soft‑tissue sarcomas, bone tumors, retinoblastoma, etc.). Major limitations/requirements include need for a recent clinical evaluation or meaningful contact (typically within 60 days) prior to advanced imaging, histologic confirmation and staging (unless a disease‑specific guideline states otherwise), physician review for atypical presentations, routine surveillance imaging of asymptomatic individuals is generally not supported, and studies not listed in the disease‑specific sections are not authorized.

"A single follow-up PET/CT (CPT ® 78815 or CPT ® 78816) or PET/MRI is indicated >12 weeks after radiation therapy (timing limitation: must be >12 weeks after radiation)."