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Radiology/Imaging Services Program Update: March 2021

Effective March 25, 2021, 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 computed tomography services represented by the recently approved procedure codes below when rendered on or after March 25, 2021.

  • 71271
  • 0633T
  • 0634T
  • 0635T
  • 0636T
  • 0637T
  • 0638T

Review the complete list of services that require PA/MND review as part of these programs.

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, weekdays, 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.

eviCore healthcare is an independent company that supports Horizon Blue Cross Blue Shield of New Jersey in the provision of Prior Authorization and/or Medical Necessity Review (PA/MND) of certain nonemergency radiology services.

Published on: February 22, 2021, 11:06 a.m. ET
Last updated on: April 22, 2021, 05:30 a.m. ET