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.

0609T
0610T
0611T
0612T
C9762
C9763

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.

PA/MND reviews

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.

Published on: December 30, 2020, 11:46 a.m. ET

Last updated on: April 27, 2021, 07:26 a.m. ET