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Update: Contrast Agents and Radiopharmaceuticals

Effective December 1, 2020, Horizon BCBSNJ will change how we process certain claims for services as part of our Radiology/Imaging Services Program and our Cardiology Imaging Program, both administered by eviCore healthcare (eviCore).

Beginning December 1, 2020, reimbursement for the services represented by the HCPCS codes below will be considered included in the reimbursement for the radiology/cardiology imaging service performed and will not be eligible for separate reimbursement.

  • A9575 Injection of a nonionic contrast medium for magnetic resonance imaging (MRI)
  • Q9957 Injection, perflutren lipid microspheres, per ml

 

You may review this and other noncovered services within our Contrast Agents and Radiopharmaceuticals listing available on the Cardiology Imaging Program and Radiology/Imaging Services web pages.

For more information about these and other eviCore programs, visit HorizonBlue.com/evicore.

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: September 1, 2020, 14:24 p.m. ET
Last updated on: September 1, 2020, 14:55 p.m. ET