Pediatric Peripheral Vascular Disease (PVD) Imaging Guidelines

This policy covers pediatric peripheral vascular disease imaging—including advanced vascular studies such as MR angiography, CT angiography, duplex ultrasonography, and other imaging for vascular anomalies, vasculitis, aortic and visceral artery disorders, and infantile hemangiomas. Advanced imaging is intended for patients <18 with documented active clinical signs/symptoms after appropriate clinical evaluation and basic imaging (plain radiography or ultrasound); asymptomatic screening is not supported and atypical presentations require physician review.

"This tool addresses common symptoms and symptom complexes."

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