Effective Sunday, May 31, 2020, NC Medicaid is terminating the auto approval for lung imaging requested through EviCore, NC Medicaid’s contracted vendor for imaging services. Beginning Monday, June 1, 2020, the following chest CT codes will require prior approval:
- 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
Previously approved imaging studies will be honored through the authorization end-date.
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.
Contact
NCTracks Contact Center: 800-688-6696