Evolent reviews certain imaging studies for the existence of an urgent/emergent situation. This type of medical necessity review is only conducted for those requests where the date of service has passed (a retrospective review). The indications below can be applied to all imaging modalities managed by Evolent. The indications presented herein are not intended to limit the peer clinical reviewer from using his/her independent clinical judgment. A case-by-case evaluation of the member’s clinical presentation should be conducted when determining the presence of an emergent or urgent 
clinical situation.

• Urgent Emergent Criteria