Transcription of eviCore Spine Imaging Guidelines
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Spine Imaging Policy Version Effective September 1 , 2021eviCore healthcare Clinical Decision Support Tool Diagnostic Strategies: This tool addresses common symptoms and symptom complexes. Imaging requests for individuals with atypical symptoms or clinical presentations that are not specifically addressed will require physician review. Consultation with the referring physician, specialist and/or individual s Primary Care Physician (PCP) may provide additional insight. CPT (Current Procedural Terminology) is a registered trademark of the American Medical Association (AMA).
Bone or Joint Imaging, Multiple 78305 Bone Scan, Whole Body 78306 Bone Scan, 3 Phase Study 78315 Radiopharmaceutical localization of tumor, inflammatory process or distribution of radiopharmaceutical agent(s) (includes vascular flow and blood pool imaging, when performed); planar, single area (e.g., head, neck, chest,
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