MRI and CT Scans of the Head and Neck
L35175
CT and MRI of the head/neck are covered when medically necessary — CT is indicated for acute CNS hemorrhage, stroke/CVA, new focal seizures, intracranial mass with increased pressure, specific headache presentations (post‑trauma, persistent >2 weeks, sudden severe), staging for cancers that commonly metastasize to brain (e.g., lung, breast, lymphoma), when MRI is contraindicated, and contrast CT is allowed for perfusion, lesion characterization, BBB defects, neovascularity and in specified repeat‑scan exceptions (CVA, non‑traumatic hemorrhage, TIA, post‑op residual/complication, known brain tumor/metastases with clinical change). Excluded/limited: routine CT/MRI for headache/dizziness without focal signs and staging for esophageal/oropharyngeal/prostate/non‑melanoma skin cancers without brain symptoms are not covered; CMS also disallows MRI for cortical bone/calcification, spatial bone resolution, aneurysm clips and certain MR flow/spectroscopy — claims must document symptoms/provisional diagnosis (and justification for contrast in trauma), use FDA‑approved equipment, and meet the specified staging and repeat‑scan criteria.