Peripheral Nerve Disorder (PND) Imaging Guidelines

This policy covers imaging evaluation for peripheral nerve disorders (PND), including ultrasound, magnetic resonance neurography/MRI, CT, and nuclear imaging, and defines their roles alongside electrodiagnostic testing. It applies to focal and polyneuropathies, brachial and lumbosacral plexus conditions, muscle disorders, ALS, peripheral nerve sheath tumors, carpal tunnel and other common peripheral nerve presentations. Major requirements/limitations: a clinical evaluation within 60 days is required before advanced imaging; ultrasound is preferred for superficial nerves, MRI/MRN is reserved for deep or bone‑obscured nerves or pre‑operative planning, CT is limited to cases where MRI is contraindicated, and advanced imaging is generally conditional when EMG/NCV and clinical findings are equivocal.

"Other meaningful contact (telephone call, electronic mail or messaging) by an established patient can substitute for a face-to-face clinical evaluation."