Update on Radiology Prior Authorizations (PA)
Maine Department of Health & Human Services sent this bulletin at 09/29/2020 09:48 AM EDT
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Update on Radiology Prior Authorizations (PA)
Effective October 1, 2020, MaineCare will no longer require PA for radiology services that previously required a PA. Please see the table below for more information.
As a reminder, MaineCare began waiving these PA requirements in March 2020 as part of our response to the COVID-19 pandemic. Moving forward, we will not reinstate the previous requirements, and you are no longer required to enter Radiology PA requests into the Health PAS Online Portal beginning on October 1, 2020.
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COMPUTERIZED TOMOGRAPHY (CTs) NO LONGER REQUIRING PA |
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|
Code |
Description |
|
70450 |
Brain /Head wo contrast |
|
70460 |
Brain/Head w/contrast |
|
70470 |
Brain/Head w/wo contrast |
|
70480 |
Orbits wo contrast |
|
70481 |
Orbits w/contrast |
|
70482 |
Orbits w/wo contrast |
|
70486 |
Sinus wo contrast |
|
70487 |
Sinus w/ contrast |
|
70488 |
Sinus w/wo contrast |
|
70490 |
Neck, Soft Tissue w/wo contrast |
|
70491 |
Neck, Soft Tissue w/contrast |
|
70492 |
Neck, Soft Tissue w/wo contrast |
|
70496 |
Angiogram Head |
|
70498 |
Angiogram Neck |
|
71250 |
Chest wo contrast |
|
71260 |
Chest w/contrast |
|
71270 |
Chest w/wo contrast |
|
71275 |
Angiogram, Chest w/contrast |
|
72125 |
Spine Cervical wo contrast |
|
72126 |
Spine Cervical w/contrast |
|
72127 |
Spine Cervical w/wo contrast |
|
72128 |
Spine, Thoracic wo contrast |
|
72129 |
Spine, Thoracic w/contrast |
|
72130 |
Spine, Thoracic w/wo contrast |
|
72131 |
Spine, Lumbar wo contrast |
|
72132 |
Spine, Lumbar w/contrast |
|
72133 |
Spine, Lumbar w/wo contrast |
|
72191 |
Pelvis Angiogram w/contrast |
|
72192 |
Pelvis wo contrast |
|
72193 |
Pelvis w/contrast |
|
72194 |
Pelvis w/wo contrast |
|
72292 |
Sacroplasty |
|
73200 |
Upper Extremity wo contrast |
|
73201 |
Upper Extremity w/contrast |
|
73202 |
Upper Extremity w/wo contrast |
|
73206 |
Upper Extremity Angiogram w/contrast |
|
73700 |
Lower Extremity wo contrast |
|
73701 |
Lower Extremity w/contrast |
|
73702 |
Lower Extremity w/wo contrast |
|
73706 |
Lower Extremity Angiogram |
|
74150 |
Abdomen wo contrast |
|
74160 |
Abdomen w/contrast |
|
74170 |
Abdomen w/wo contrast |
|
74174 |
Abdomen & Pelvis, Angiogram w/wo contrast |
|
74175 |
Abdomen, Angiogram/AAA w/contrast |
|
74176 |
Abdomen & Pelvis, Renal Stone wo contrast |
|
74177 |
Abdomen & Pelvis, Enterography |
|
74178 |
Abdomen & Pelvis, Urogram w/wo contrast |
|
74261 |
Diagnostic Virtual Colonoscopy w/o contract |
|
74262 |
Diagnostic Virtual Colonoscopy w/contract |
|
75571 |
Heart, CACA wo contrast |
|
75572 |
Cardiac CT w/3d image |
|
75573 |
Cardiac CT w/3d image, congen |
|
75574 |
Cardiac CT angio heart, w/3d image |
|
75635 |
Abdomen, angio aorta Runoff w/contrast |
|
76376 |
3D rendering with interpretation and reporting of computed tomography |
|
76377 |
Fluoroguide for spine inject TTE w/o Doppler complete |
|
76380 |
Sinus Limited |
|
77078 |
Bone Mineral Density Study one or more sites |
|
92025 |
Corneal Topography, unilateral or bilateral |
Please contact your Provider Relations Specialist with questions.