SPECIAL BULLETIN COVID-19 #13: EviCore Chest Computed Tomography (CT) Auto-Approval

In response to the anticipated spread of the novel coronavirus (COVID-19) in North Carolina, EviCore, NC Medicaid’s contracted vendor for imaging services, will auto-approve the following chest CT codes effective immediately:

• 71250 – Computed tomography, thorax; without contrast material
• 71260 – Computed tomography, thorax; with contrast material(s)
• 71270 – Computed tomography, thorax; without contrast material, followed by contrast material(s) and further sections

A provider questionnaire will ask if the test is being requested due to COVID-19; if the answer is yes, the test will be automatically approve, regardless of diagnosis. If the answer is no, the request will process as usual.

As a reminder, if the CT is ordered by an urgent care facility or emergency department, the U2 modifier should be appended to the claim indicating that the test was performed emergently, and prior approval is not required.

Additional provider notification will be provided alerting providers if or when the auto-approval process changes or additional services are added to the list above.

GDIT 800-688-6696