SPECIAL BULLETIN COVID-19 #92: Coronavirus (COVID-19) EviCore Chest Computed Tomography (CT) Auto-Approval Ending May 31, 2020

Friday, May 29, 2020

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