Neurological Deficit
Vascular
Nerves
Eyes, Ears, Nose, Face
Tumors
100

This GL can be used for an adult with Ataxia.

What is GL HD-3 Ataxia?

100

This GL can be used for an adult member having slurred speech and the MDO wants to R/O a Stroke.

What is GL HD 21.1 Stroke/TIA?

100

This GL can be used for a member with facial weakness

What is HD 6.1 Facial Palsy?

100

This GL could be used for a member having loss of vision.

What is HD 32.1 Eye disorders?

100

This GL could be used for an adult member with a Pituitary tumor.

What is HD-19.1: Pituitary?

200

This guideline can be used for a patient with neurological deficits on exam after a head trauma

What is HD-13.1 head trauma?


200

This GL can be used for an Arteriovenous Malformation in an adult member.

What is HD 12.2 Arteriovenous Malformations (AVMs) and Related Lesions?

200

This GL can be used for an adult member experiencing a tingling sensation along her right side.

What is HD- 18 Paresthesias?

200

This GL can be used for this member suffering from anosmia.

What is GL HD-2 Taste and Smell Disorders.

200

This GL could be used for a Pediatric member for an arachnoid cyst.

What is PEDHD-13.1: Arachnoid Cysts?

300

This GL could be used for a history of an adult with memory loss and diagnoses of Dementia.

What is HD-8.1 Dementia?

300

This GL can be used for a pediatric member with slurred speech and the physician wants to R/O a stroke.

What is PEDHD-12.2 Pediatric Stroke Initial Imaging

300

This GL could be used for a patient who has lost the sense of taste.

What is GL HD 2.1 Taste and Smell Disorders?

300

This GL can be used for a pediatric member suffering congestion of the sinuses.

PEDHD-5 Sinusitis and Allergic Rhinitis.

300

This GL can be used for an adult member with an Acoustic Neuroma.

What is HD-33.1: Acoustic Neuroma and Other Cerebellopontine Angle Tumors?

400

This GL can be used if there is a Headache accompanied by a neurological deficit in an adult.


What is HD 11.2 Headaches with Abnormal Findings on Examination/Red Flags?



400

This GL can be used for an adult member with a first degree family member with an aneurysm and the provider wants to R/O an aneurysm

What is HD-12.1 Intracranial Aneurysms?

400

This GL can be used for a pediatric member having a neuropathy of the glossopharyngeal nerve.

What is PEDHD-23: Cranial Neuropathies?

400

This GL could be used for a pediatric member with a nose bleed.

What is GL PEDHD 21.1 Epistaxis?

400

This GL can be used for a mass noted on the top of the head by an adult member.

What is GL HD-20.1 Scalp and Skull Lesions?

500

This GL can be used if there is concern for Multiple sclerosis in a pediatric member.

What is GL PEDHD-14.2: Multiple Sclerosis (MS)

500

This GL could be used for a pediatric patient with Moyamoya disease.

What is GL PEDHD 12.4 MoyaMoya Disease?

500

This GL could be used for an adult patient with facial numbness

What is HD 10.1 Trigeminal Neuralgia/Trigeminal Neuropathy?

500

This GL can be used for a member who had facial trauma.

What is GL PEDHD 4.2 Facial Trauma

500

This GL could be used for an adult member if there was a Headache and R/O brain tumor.

What is HD-11: Headache?