eviCore Program Updates: Radiology/Imaging Services and Cardiology Imaging
Effective February 1, 2021, Horizon BCBSNJ will implement changes to the services included as part of our Radiology/Imaging Services Program and our Cardiology Imaging Program, both administered by eviCore healthcare (eviCore).
eviCore will conduct Prior Authorization/Medical Necessity Determination (PA/MND) reviews of the MRI and Cardiac MRI services represented by the recently approved procedure codes below when rendered on or after February 1, 2021.
Review the complete list of services that require PA/MND review as part of these programs.
For more information about these and other eviCore programs, visit HorizonBlue.com/evicore. If you have questions, please contact your Network Specialist or Ancillary Contracting Specialist.
CPT® is a registered trademark of the American Medical Association.
To submit a PA/MND request to eviCore (or to validate that a PA/MND was requested and/or approved) please:
- Visit eviCore.com or
- Call 1-866-496-6200, between 7 a.m. and 7 p.m., Eastern Time
Review the guidelines eviCore uses to conduct PA/MND reviews as part of this program.