New preauthorization requirement changes will take affect for plans on or after April 1, 2014. The changes affect the following benefits:
High Tech Non-Emergency Imaging Procedures
- All high tech, non-emergency imaging procedures will require preauthorization including (preauthorization for the above services is not being added for Traditional members):
- MRI (Magnetic Resonance Imaging)
- MRA (Magnetic Resonance Angiography)
- CT (Computerized Tomography) Scans
- CTA ( Computerized Tomography Angiography) Scans
- PET (Positron Emission Tomography) Scans
- SPECT (Single Proton Emission Computerized Tomography) Scans
Observation Care
- All observation cases will require preauthorization for continued observation status that exceeds or is expected to exceed 48 hours.
Radiofrequency Ablation for Pain Management/Denervation of Facet Joint Pain Management
- Radiofrequency ablation for pain management (Facet Joint Denervation) will require preauthorization.