Preface to the Imaging Guidelines

This policy covers EviCore’s evidence‑based imaging guidelines for advanced imaging and designated procedures—including NM, US, CT, MRI, PET, radiation oncology, sleep studies, gastrointestinal endoscopy, and cardiac, musculoskeletal, and spine interventions—applied to common symptoms and typical clinical conditions experienced by the majority of patients. Approvals require demonstration of medical necessity based on the individual’s clinical presentation (not just the requested study), submission of adequate clinical information (e.g., prior x‑rays for spine/musculoskeletal cases), and are subject to payer coverage, state/federal laws; atypical presentations, investigational/clinical trial requests, or cases outside the tool may need physician review or payer-specific authorization.

"Infusion catheters and bullets or shrapnel"

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