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High End Imaging - Cardiac imaging and elective heart catheterization
Last Updated on July 23, 2019
High end imaging
Security Health Plan requires prior notification for outpatient high-end imaging tests for cardiac imaging and elective heart catheterization. A complete list of CPT codes requiring notification can be found below. Services performed without authorization may be denied for payment; and you may not seek reimbursement from members.
A prior notification is required for affiliated providers, facilities and ancillary providers for aforementioned high-end imaging procedures prior to performance, with administrative claim denial for non-compliance. The ordering provider maintains final decision authority of which high-end imaging test is performed. If an affiliated provider fails to prior notify, retro-notification will not be accepted.
The ordering provider or designee is responsible for obtaining a notification number prior to scheduling high-end outpatient imaging procedures. Prior notification can be completed on-line via Security Health Plan’s provider portal.
Authorization is required for:
- Cardiac Advanced Imaging: CT, MR, PET
- Nuclear Cardiology (includes nuclear stress testing)
- Echo Stress Testing
- Echocardiography
- Diagnostic Heart Catheterization
Request Authorization
- Register online for an account
- Online – 24 hours a day, seven days a week at www.medsolutionsonline.com
To request an authorization, submit your request online, by phone or fax:
Call eviCore at 1-888-693-3211 and choose option 4 for physicians. Here, providers may request or schedule a live peer-to-peer conversation. Please have the case or authorization number on the denial/fax letter ready.
- Log into www.medsolutionsonline.com
- Phone at 1-888-444-6185
- Fax a eviCore request form (available online) to 1-885-511-0403
Resources
View code list for high end imaging prior authorizations for cardiac studies and elective heart catheterization
eviCore FAQs
eviCore healthcare’s Clinical Guidelines and request forms are available at: www.evicore.com or click here to access guidelines specific to Security Health Plan. Please call the Client Provider Operations department at 1-800-646-0418, option 4, if you have any questions or need more information.