Peripheral Vascular Disease (PVD) Imaging Guidelines

EviCore deems duplex US, CTA, MRA, CT and select nuclear/PET studies medically necessary for specified carotid, aortic, peripheral arterial and venous indications (including post‑operative surveillance, aneurysm/dissection management, renovascular disease, and graft/infection evaluation) but excludes routine asymptomatic PAD screening, most nuclear or experimental plaque‑quantification studies, and routine repeat imaging without change. Advanced imaging requires documented clinical evaluation or meaningful contact since symptom onset, appropriate initial tests (eg, ABI and/or duplex as first‑line), evidence of change or specific surveillance timepoints (eg, ABI drop >0.15, abnormal duplex, worsening symptoms, indeterminate prior study), and adherence to stated modality preferences and documentation (including family/genetic history when indicated).

"Prior to advanced imaging, a pertinent clinical evaluation or meaningful technological contact since symptom onset/worsening is required (see Documentation Requirements)."