Peripheral Nerve Disorder (PND) Imaging Guidelines

Advanced imaging (US, MRI, CT) for peripheral nerve disorders is covered when clinically indicated for focal neuropathies, plexopathies, muscle/neuromuscular disorders and peripheral nerve sheath tumors—ultrasound is preferred for superficial nerves, MRI for deep or bone‑obscured nerves and surgical planning, CT only when MRI is contraindicated—and MRN and most nuclear medicine/PET applications are limited or considered investigational. Coverage requires documented pertinent clinical evaluation (history, neurological exam, relevant labs and prior imaging), and, where specified, EMG/NCV (unless waived), preauthorization/justification for repeat studies, and documentation of failed conservative therapy when required.

"Advanced imaging (US, MRI, CT as specified) after a pertinent clinical evaluation (history, physical including neurological exam, appropriate labs, non-advanced imaging, and EMG/NCV) for peripheral..."