Magnetic Resonance Imaging (MRI) of the Prostate - (Effective Date - 2026-10-15) 6.01.46
Summary
MRI of the pelvis is considered medically appropriate for men with suspected prostate cancer who meet one of the listed indications, including men aged 40 to 75 with a PSA greater than 3 ng/ml or a very suspicious digital rectal exam plus a listed high-risk feature, men aged 45 to 75 with a PSA greater than 3 ng/ml or a very suspicious digital rectal exam, and men older than 75 with a PSA of 4 ng/ml or greater or a very suspicious digital rectal exam. A 06/18/26 update removed very low risk from the NCCN initial risk stratification criteria, added new criteria for suspected prostate cancer and for restaging, removed criteria for non-metastatic prostate cancer previously treated with prostatectomy, radiation therapy, ablation hormonal therapy or chemotherapy where PSA does not fall after prostatectomy, and removed the salvage local therapy criteria. Serial MRIs are considered not medically necessary when monitoring an elevated PSA for suspected prostate cancer, and MR guidance for needle placement is not medically necessary for prostate biopsy.
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