Pediatric Peripheral Vascular Disease (PVD) Imaging Guidelines

This policy governs imaging for pediatric peripheral vascular disease — including ultrasound, duplex and noninvasive physiologic extremity and extracranial vascular studies and, when appropriate, advanced imaging (CT/MR/nuclear) for conditions such as vascular anomalies, vasculitis, aortic and visceral artery disorders, and infantile hemangiomas in patients <18 years. Major requirements/limitations: advanced imaging generally requires documented active signs/symptoms plus a prior pertinent clinical evaluation and basic imaging (unless guideline‑scheduled), atypical or unaddressed presentations need physician review, screening asymptomatic children and routine repeat studies are not supported, and MRI contrast use is restricted by gadolinium contraindications with anesthesia minimized for MRI (neonates excepted).

"Vascular Anomalies (PEDPVD-2)"

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