Clinical Guidelines
Welcome to the NIA Clinical Guidelines page. The guidelines have been developed from practice experience, literature reviews, specialty criteria sets, and empirical data. All revisions of these guidelines are the result of a scientific process of clinical consensus, approved by the NIA Chief Medical Officer, Chief Executive Officer and Board of Directors.
In each application sent to an individual health plan, the submission is reviewed and approved by the plan Medical Director. The approval is consistent with the plan's internal quality, utilization management functions, coverage packages and applicable accrediting agencies.
It is important to note that NIA processes hundreds of thousands of requests per month using these guidelines. This information is essential. On an empirical basis one could not successfully review the large volume of cases unless the criteria used represented "mainstream" medicine.
NIA reviewers use the criteria sets in the day-to-day operation of the Call Center. Any MRI, CT, Nuclear Cardiology, PET or study not found in this document will be sent for a doctor-to-doctor review.
We have not included specific literature references in this document. If this is of concern to you, you may contact your health plan Medical Director and he/she will give you further guidance.
Respectfully Submitted,
Thomas G. Dehn, M.D., FACR
Executive Vice President, Chief Medical Officer
National Imaging Associates, Inc.
Additional Information
Follow these simple steps to access the guideline:
- Click on the "Clinical Guideline Search" button near the top or on the left side of the page (listed above Health Plans)
- From a drop down list on the NIA Clinical Guideline page, select the appropriate health plan.
- Next, select the type of study or modality that you want to review.
- Lastly, select the exam you want to review. A PDF document will open the guideline selected.
NIA's clinical algorithms are focused on advanced imaging studies such as MRI, MRA, CT, PET and Nuclear Cardiology. These clinical algorithms are predominantly and directly derived from those of the esteemed professional medical societies. For further information on these please visit:
ACR.org for the American College of Radiology's information
ACC.org for the American College of Cardiology's information
ACOG.org for the American College of Obstetricians and Gynecologists