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Clinical Appropriateness Guidelines: Advanced Imaging

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Clinical Appropriateness Guidelines: Advanced Imaging Clinical Appropriateness Guidelines: Advanced Imaging Imaging Program Guidelines: Pediatric Imaging Effective Date: February 20, 2017 Proprietary Guideline Last Revised Last Reviewed Administrative 07-26-2016 07-26-2016 Head and Neck 11-01-2016 11-01-2016 Chest 08-27-2015 07-26-2016 Abdomen and Pelvis 11-01-2016 11-01-2016 Spine 08-27-2015 07-26-2016 Extremity 08-27-2015 07-26-2016 ARCHIVED 8600 W Bryn Mawr Avenue South Tower – Suite 800 Chicago, IL 60631 P. 773.864.4600 Copyright © 2017. AIM Specialty Health. All Rights Reserved www.aimspecialtyhealth.com Table of Contents Description and Application of the Guidelines ........................................................................4 Administrative Guidelines ........................................................................................................5 Ordering of Multiple Studies ...................................................................................................................................5 Pre-test Requirements ...........................................................................................................................................6 Head & Neck Imaging ...............................................................................................................7 CT of the Head – Pediatrics ...................................................................................................................................7 MRI of the Head/Brain – Pediatrics ......................................................................................................................14 CTA/MRA Head: Cerebrovascular – Pediatrics ....................................................................................................21 Functional MRI (fMRI) Brain – Pediatrics .............................................................................................................24 PET Brain Imaging – Pediatrics ...........................................................................................................................25 CT Orbit, Sella Turcica, Posterior Fossa, Temporal Bone, including Mastoids – Pediatrics ................................26 CT Paranasal Sinus & Maxillofacial Area – Pediatrics .........................................................................................29 MRI Orbit, Face & Neck (Soft Tissues) – Pediatrics ............................................................................................32 MRI Temporomandibular Joint (TMJ) – Pediatrics ...............................................................................................36 CT Neck for Soft Tissue Evaluation – Pediatrics ..................................................................................................37 CTA/MRA of the Neck – Pediatrics .......................................................................................................................40 Chest Imaging .........................................................................................................................42 CT Chest – Pediatrics ..........................................................................................................................................42 CTA of the Chest (Non-Coronary) – Pediatrics ...................................................................................................47 MRI Chest – Pediatrics ........................................................................................................................................49 MRA of the Chest – Pediatrics .............................................................................................................................52 Abdominal & Pelvic Imaging ..................................................................................................54 CT Abdomen – Pediatrics .....................................................................................................................................54 MRI Abdomen – Pediatrics ...................................................................................................................................65 MR Cholangiopancreatography (MRCP) Abdomen – Pediatrics .........................................................................74 CTA and MRA of the Abdomen - Pediatrics..........................................................................................................76 CT Pelvis – Pediatrics ..........................................................................................................................................79 MRI Pelvis – PediatricsARCHIVED ........................................................................................................................................85 CTA and MRA of the Pelvis – Pediatrics ..............................................................................................................91 CT of the Abdomen & Pelvis Combination – Pediatrics .......................................................................................93 CTA of the Abdomen and Pelvis Combination – Pediatrics ................................................................................101 Table of Contents – Pediatrics | Copyright © 2017. AIM Specialty Health. All Rights Reserved. 2 Spine Imaging .......................................................................................................................103 CT Cervical Spine – Pediatrics ...........................................................................................................................103 MRI Cervical Spine – Pediatrics .........................................................................................................................106 CT Thoracic Spine – Pediatrics ..........................................................................................................................110 MRI Thoracic Spine – Pediatrics ........................................................................................................................113 CT Lumbar Spine – Pediatrics ...........................................................................................................................117 MRI Lumbar Spine – Pediatrics .........................................................................................................................120 MRA Spinal Canal – Pediatrics ..........................................................................................................................124 Extremity Imaging .................................................................................................................125 CT Upper Extremity – Pediatrics ........................................................................................................................125 MRI Upper Extremity (Any Joint) – Pediatrics ....................................................................................................128 MRI Upper Extremity (Non-Joint) – Pediatrics ...................................................................................................132 CTA and MRA Upper Extremity – Pediatrics ......................................................................................................135 CT Lower Extremity – Pediatrics ........................................................................................................................137 MRI Lower Extremity (Joint & Non-Joint) – Pediatrics .......................................................................................140 CTA and MRA Lower Extremity – Pediatrics ......................................................................................................147 ARCHIVED Table of Contents – Pediatrics | Copyright © 2017. AIM Specialty Health. All Rights Reserved. 3 Description and Application of the Guidelines AIM’s Clinical Appropriateness Guidelines (hereinafter “AIM’s Clinical Appropriateness Guidelines” or the “Guidelines”) are designed to assist providers in making the most appropriate treatment decision for a specific clinical condition for an individual. As used by AIM, the Guidelines establish objective and evidence-based, where possible, criteria for medical necessity determinations. In the process, multiple functions are accomplished: ● To establish criteria for when services are medically necessary ● To assist the practitioner as an educational tool ● To encourage standardization of medical practice patterns ● To curtail the performance of inappropriate and/or duplicate services ● To advocate for patient safety concerns ● To enhance the quality of healthcare ● To promote the most efficient and cost-effective use of services AIM’s guideline development process complies with applicable accreditation standards, including the requirement that the Guidelines be developed with involvement from appropriate providers with current clinical expertise relevant to the Guidelines under review and be based on the most up to date clinical principles and best practices. Relevant citations are included in the “References” section attached to each Guideline. AIM reviews all of its Guidelines at least annually. AIM makes its Guidelines publicly available on its website twenty-four hours a day, seven days a week. Copies of AIM’s Clinical Appropriateness Guidelines are also available upon oral or written request. Although the Guidelines are publicly-available, AIM considers the Guidelines to be important, proprietary information of AIM, which cannot be sold, assigned, leased, licensed, reproduced or distributed without the written consent
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