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Radiology/Imaging Services Program: PET Scan Services Update

In February 2020, Horizon BCBSNJ will implement changes to the services included as part of our Radiology/Imaging Services Program administered by eviCore healthcare (eviCore).

eviCore will conduct Prior Authorization/Medical Necessity Determination (PA/MND) reviews of the following PET Scan service procedure codes when rendered on or after February 3, 2020:

78429
78430
78431
78432
78433

Review the complete list of services that require PA/MND review as part of this program.

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: January 3, 2020, 02:51 a.m. ET
Last updated on: January 3, 2020, 02:55 a.m. ET