Spine Imaging Guidelines

eviCore authorizes advanced spinal imaging (MRI, CT, CT/myelography, and select PET/ultrasound/nuclear uses) for evaluation of disc disease, spinal cord/nerve root disorders, neoplasm surveillance, infection, fracture, cauda equina, severe radicular pain, pre-/post‑operative concerns and other defined red‑flag indications, but considers positional (dynamic) MRI, cone‑beam CT for the cervical spine, routine (non‑neoplastic) spine PET, adult spinal canal ultrasound and many myelogram/discography procedures experimental/investigational or excluded (only specific post‑myelogram/post‑discography CT codes are authorized). Key requirements: an initial face‑to‑face clinical evaluation within 60 days and, for most non‑urgent requests, documented failure of a recent 6‑week provider‑directed treatment with clinical re‑evaluation (plain x‑rays when specified) plus detailed neurologic documentation (motor grading, dermatomal sensory findings, reflexes, treatment trials); red‑flag or emergent signs allow prompt imaging.