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Home Hearing Loss and/or Vertigo
Variants
Scenario Scenario ID Procedure Adult RRL Peds RRL Appropriateness Category
Hearing loss, conductive, no mass in ear, initial exam 3141492
CT temporal bone without IV contrast
1-10 mSv
☢☢☢
Usually appropriate
MRA head without and with IV contrast
0 mSv
O 		0 mSv [ped]
O 		Usually not appropriate
MRA head without IV contrast
0 mSv
O 		0 mSv [ped]
O 		Usually not appropriate
MRI head and internal auditory canal without and with IV contrast
0 mSv
O 		0 mSv [ped]
O 		Usually not appropriate
MRI head and internal auditory canal without IV contrast
0 mSv
O 		0 mSv [ped]
O 		Usually not appropriate
MRV head without IV contrast
0 mSv
O 		0 mSv [ped]
O 		Usually not appropriate
CT head with IV contrast
1-10 mSv
☢☢☢ 		0.3-3 mSv [ped]
☢☢☢ 		Usually not appropriate
CT head without and with IV contrast
1-10 mSv
☢☢☢ 		3-10 mSv [ped]
☢☢☢☢ 		Usually not appropriate
CT head without IV contrast
1-10 mSv
☢☢☢ 		0.3-3 mSv [ped]
☢☢☢ 		Usually not appropriate
CT temporal bone with IV contrast
1-10 mSv
☢☢☢
Usually not appropriate
CT temporal bone without and with IV contrast
1-10 mSv
☢☢☢
Usually not appropriate
CTA head with IV contrast
1-10 mSv
☢☢☢ 		3-10 mSv [ped]
☢☢☢☢ 		Usually not appropriate
Scenario Scenario ID Procedure Adult RRL Peds RRL Appropriateness Category
Neoplasm with suspected intracranial or inner ear extension, surgical planning 3141663
MRI head and internal auditory canal without and with IV contrast
0 mSv
O 		0 mSv [ped]
O 		Usually appropriate
CT temporal bone without IV contrast
1-10 mSv
☢☢☢
Usually appropriate
MRI head and internal auditory canal without IV contrast
0 mSv
O 		0 mSv [ped]
O 		May be appropriate
CT temporal bone with IV contrast
1-10 mSv
☢☢☢
May be appropriate
CTA head with IV contrast
1-10 mSv
☢☢☢ 		3-10 mSv [ped]
☢☢☢☢ 		May be appropriate
(Disagreement)
MRA head without and with IV contrast
0 mSv
O 		0 mSv [ped]
O 		Usually not appropriate
MRA head without IV contrast
0 mSv
O 		0 mSv [ped]
O 		Usually not appropriate
MRV head with IV contrast
0 mSv
O 		0 mSv [ped]
O 		Usually not appropriate
MRV head without IV contrast
0 mSv
O 		0 mSv [ped]
O 		Usually not appropriate
CT head with IV contrast
1-10 mSv
☢☢☢ 		0.3-3 mSv [ped]
☢☢☢ 		Usually not appropriate
CT head without and with IV contrast
1-10 mSv
☢☢☢ 		3-10 mSv [ped]
☢☢☢☢ 		Usually not appropriate
CT head without IV contrast
1-10 mSv
☢☢☢ 		0.3-3 mSv [ped]
☢☢☢ 		Usually not appropriate
CT temporal bone without and with IV contrast
1-10 mSv
☢☢☢
Usually not appropriate
Cholesteatoma, surgical planning 3141662
MRI head and internal auditory canal without and with IV contrast
0 mSv
O 		0 mSv [ped]
O 		Usually appropriate
CT temporal bone without IV contrast
1-10 mSv
☢☢☢
Usually appropriate
MRI head and internal auditory canal without IV contrast
0 mSv
O 		0 mSv [ped]
O 		May be appropriate
CT temporal bone with IV contrast
1-10 mSv
☢☢☢
May be appropriate
CTA head with IV contrast
1-10 mSv
☢☢☢ 		3-10 mSv [ped]
☢☢☢☢ 		May be appropriate
(Disagreement)
MRA head without and with IV contrast
0 mSv
O 		0 mSv [ped]
O 		Usually not appropriate
MRA head without IV contrast
0 mSv
O 		0 mSv [ped]
O 		Usually not appropriate
MRV head with IV contrast
0 mSv
O 		0 mSv [ped]
O 		Usually not appropriate
MRV head without IV contrast
0 mSv
O 		0 mSv [ped]
O 		Usually not appropriate
CT head with IV contrast
1-10 mSv
☢☢☢ 		0.3-3 mSv [ped]
☢☢☢ 		Usually not appropriate
CT head without and with IV contrast
1-10 mSv
☢☢☢ 		3-10 mSv [ped]
☢☢☢☢ 		Usually not appropriate
CT head without IV contrast
1-10 mSv
☢☢☢ 		0.3-3 mSv [ped]
☢☢☢ 		Usually not appropriate
CT temporal bone without and with IV contrast
1-10 mSv
☢☢☢
Usually not appropriate
Scenario Scenario ID Procedure Adult RRL Peds RRL Appropriateness Category
Hearing loss, sensorineural, initial exam 3074300
MRI head and internal auditory canal without and with IV contrast
0 mSv
O 		0 mSv [ped]
O 		Usually appropriate
MRI head and internal auditory canal without IV contrast
0 mSv
O 		0 mSv [ped]
O 		Usually appropriate
CT temporal bone with IV contrast
1-10 mSv
☢☢☢
May be appropriate
CT temporal bone without IV contrast
1-10 mSv
☢☢☢
May be appropriate
MRA head without and with IV contrast
0 mSv
O 		0 mSv [ped]
O 		Usually not appropriate
MRA head without IV contrast
0 mSv
O 		0 mSv [ped]
O 		Usually not appropriate
MRV head with IV contrast
0 mSv
O 		0 mSv [ped]
O 		Usually not appropriate
MRV head without IV contrast
0 mSv
O 		0 mSv [ped]
O 		Usually not appropriate
CT head with IV contrast
1-10 mSv
☢☢☢ 		0.3-3 mSv [ped]
☢☢☢ 		Usually not appropriate
CT head without and with IV contrast
1-10 mSv
☢☢☢ 		3-10 mSv [ped]
☢☢☢☢ 		Usually not appropriate
CT head without IV contrast
1-10 mSv
☢☢☢ 		0.3-3 mSv [ped]
☢☢☢ 		Usually not appropriate
CT temporal bone without and with IV contrast
1-10 mSv
☢☢☢
Usually not appropriate
CTA head with IV contrast
1-10 mSv
☢☢☢ 		3-10 mSv [ped]
☢☢☢☢ 		Usually not appropriate
Scenario Scenario ID Procedure Adult RRL Peds RRL Appropriateness Category
Hearing loss, mixed conductive and sensorineural, initial exam 3074301
MRI head and internal auditory canal without and with IV contrast
0 mSv
O 		0 mSv [ped]
O 		Usually appropriate
MRI head and internal auditory canal without IV contrast
0 mSv
O 		0 mSv [ped]
O 		Usually appropriate
CT temporal bone without IV contrast
1-10 mSv
☢☢☢
Usually appropriate
MRA head without and with IV contrast
0 mSv
O 		0 mSv [ped]
O 		Usually not appropriate
MRA head without IV contrast
0 mSv
O 		0 mSv [ped]
O 		Usually not appropriate
MRV head with IV contrast
0 mSv
O 		0 mSv [ped]
O 		Usually not appropriate
MRV head without IV contrast
0 mSv
O 		0 mSv [ped]
O 		Usually not appropriate
CT head with IV contrast
1-10 mSv
☢☢☢ 		0.3-3 mSv [ped]
☢☢☢ 		Usually not appropriate
CT head without and with IV contrast
1-10 mSv
☢☢☢ 		3-10 mSv [ped]
☢☢☢☢ 		Usually not appropriate
CT head without IV contrast
1-10 mSv
☢☢☢ 		0.3-3 mSv [ped]
☢☢☢ 		Usually not appropriate
CT temporal bone with IV contrast
1-10 mSv
☢☢☢
Usually not appropriate
CT temporal bone without and with IV contrast
1-10 mSv
☢☢☢
Usually not appropriate
CTA head with IV contrast
1-10 mSv
☢☢☢ 		3-10 mSv [ped]
☢☢☢☢ 		Usually not appropriate
Scenario Scenario ID Procedure Adult RRL Peds RRL Appropriateness Category
Cochlear implant candidate, surgical planning 3074305
MRI head and internal auditory canal without and with IV contrast
0 mSv
O 		0 mSv [ped]
O 		Usually appropriate
MRI head and internal auditory canal without IV contrast
0 mSv
O 		0 mSv [ped]
O 		Usually appropriate
CT temporal bone without IV contrast
1-10 mSv
☢☢☢
Usually appropriate
MRA head without and with IV contrast
0 mSv
O 		0 mSv [ped]
O 		Usually not appropriate
MRA head without IV contrast
0 mSv
O 		0 mSv [ped]
O 		Usually not appropriate
MRV head with IV contrast
0 mSv
O 		0 mSv [ped]
O 		Usually not appropriate
MRV head without IV contrast
0 mSv
O 		0 mSv [ped]
O 		Usually not appropriate
CT head with IV contrast
1-10 mSv
☢☢☢ 		0.3-3 mSv [ped]
☢☢☢ 		Usually not appropriate
CT head without and with IV contrast
1-10 mSv
☢☢☢ 		3-10 mSv [ped]
☢☢☢☢ 		Usually not appropriate
CT head without IV contrast
1-10 mSv
☢☢☢ 		0.3-3 mSv [ped]
☢☢☢ 		Usually not appropriate
CT temporal bone with IV contrast
1-10 mSv
☢☢☢
Usually not appropriate
CT temporal bone without and with IV contrast
1-10 mSv
☢☢☢
Usually not appropriate
CTA head with IV contrast
1-10 mSv
☢☢☢ 		3-10 mSv [ped]
☢☢☢☢ 		Usually not appropriate
Scenario Scenario ID Procedure Adult RRL Peds RRL Appropriateness Category
Vertigo, episodic, peripheral, initial exam 3074303
MRI head and internal auditory canal without and with IV contrast
0 mSv
O 		0 mSv [ped]
O 		Usually appropriate
MRI head and internal auditory canal without IV contrast
0 mSv
O 		0 mSv [ped]
O 		Usually appropriate
CT temporal bone without IV contrast
1-10 mSv
☢☢☢
Usually appropriate
MRA head and neck without and with IV contrast
0 mSv
O 		0 mSv [ped]
O 		May be appropriate
CTA head and neck with IV contrast
1-10 mSv
☢☢☢ 		3-10 mSv [ped]
☢☢☢☢ 		May be appropriate
MRA head and neck without IV contrast
0 mSv
O 		0 mSv [ped]
O 		Usually not appropriate
MRV head with IV contrast
0 mSv
O 		0 mSv [ped]
O 		Usually not appropriate
MRV head without IV contrast
0 mSv
O 		0 mSv [ped]
O 		Usually not appropriate
CT head with IV contrast
1-10 mSv
☢☢☢ 		0.3-3 mSv [ped]
☢☢☢ 		Usually not appropriate
CT head without and with IV contrast
1-10 mSv
☢☢☢ 		3-10 mSv [ped]
☢☢☢☢ 		Usually not appropriate
CT head without IV contrast
1-10 mSv
☢☢☢ 		0.3-3 mSv [ped]
☢☢☢ 		Usually not appropriate
CT temporal bone with IV contrast
1-10 mSv
☢☢☢
Usually not appropriate
CT temporal bone without and with IV contrast
1-10 mSv
☢☢☢
Usually not appropriate
Scenario Scenario ID Procedure Adult RRL Peds RRL Appropriateness Category
Vertigo, persistent, central, initial exam 3074304
MRI head and internal auditory canal without and with IV contrast
0 mSv
O 		0 mSv [ped]
O 		Usually appropriate
MRI head and internal auditory canal without IV contrast
0 mSv
O 		0 mSv [ped]
O 		Usually appropriate
MRA head and neck without and with IV contrast
0 mSv
O 		0 mSv [ped]
O 		May be appropriate
MRA head and neck without IV contrast
0 mSv
O 		0 mSv [ped]
O 		May be appropriate
CT head with IV contrast
1-10 mSv
☢☢☢ 		0.3-3 mSv [ped]
☢☢☢ 		May be appropriate
CT head without IV contrast
1-10 mSv
☢☢☢ 		0.3-3 mSv [ped]
☢☢☢ 		May be appropriate
CTA head and neck with IV contrast
1-10 mSv
☢☢☢ 		3-10 mSv [ped]
☢☢☢☢ 		May be appropriate
MRV head with IV contrast
0 mSv
O 		0 mSv [ped]
O 		Usually not appropriate
MRV head without IV contrast
0 mSv
O 		0 mSv [ped]
O 		Usually not appropriate
CT head without and with IV contrast
1-10 mSv
☢☢☢ 		3-10 mSv [ped]
☢☢☢☢ 		Usually not appropriate
CT temporal bone with IV contrast
1-10 mSv
☢☢☢
Usually not appropriate
CT temporal bone without and with IV contrast
1-10 mSv
☢☢☢
Usually not appropriate
CT temporal bone without IV contrast
1-10 mSv
☢☢☢
Usually not appropriate
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