Magnetic Resonance Imaging (MRI) and Computed Tomography (CT) of the Spine (CPB 0236, reviewed 2026-04-09)
Aetna's clinical policy bulletin covers magnetic resonance imaging (MRI) and computed tomography (CT) of the spine and lists the indications it considers medically necessary. These include clinical evidence of spinal stenosis, clinical suspicion of spinal cord or cauda equina compression, congenital anomalies or deformities of the spine, and known or suspected myelopathy when MRI of the brain is negative or symptoms mimic other spinal or brainstem lesions. The bulletin also lists persistent back or neck pain with radiculopathy and objective motor or reflex changes in the specific nerve root distribution with no improvement after 6 weeks of conservative therapy, spondylolisthesis and degenerative disease of the spine that has not responded to 4 weeks of conservative therapy, suspected spinal fracture or dislocation secondary to trauma when plain films are not conclusive, suspected spinal cord injury secondary to trauma, and suspected infectious process or spinal tumors. Aetna considers BoneMRI (MRI-based synthetic CT) experimental, investigational or unproven for pre-operative assessment and surgical planning of the spine and pelvis and for diagnosing or monitoring tumors. Aetna considers MRI and CT of the spine experimental, investigational or unproven for all other indications not listed, and considers MRI for further evaluation of unstable injury in neurologically intact individuals with blunt trauma after a negative cervical spine CT not medically necessary.