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Radiology/Imaging Services Program Update: February 2019

Horizon Blue Cross Blue Shield of New Jersey 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 additional MRI services represented by the codes below (recently approved by the American Medical Association), when rendered on and after February 15, 2019

  • 77046
  • 77047
  • 77048
  • 77049
  • 76391

Effective January 1, 2019, eviCore will no longer conduct PA/MND of the services represented by the following deleted codes as part of this program.

  • 77058
  • 77059
  • C8904
  • C8907

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

For more information about this 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 16, 2019, 02:18 a.m. ET
Last updated on: January 16, 2019, 08:34 a.m. ET