Musculoskeletal and Pain Management Program …

•190+ board-certified medical directors • Diverse representation of medical specialties • 450 nurses with diverse specialties and experience • Dedicated nursing and physician

  Programs, Management, Board, Pain, Musculoskeletal, Musculoskeletal and pain management program

Cigna Musculoskeletal Program Interventional Pain ...

1 July 2016 Cigna Musculoskeletal Program Interventional Pain Management . Frequently Asked Questions . Note: Prior authorization requests should only include those codes for the current Interventional

  Programs, Management, Frequently, Pain, Interventional, Musculoskeletal, Musculoskeletal program interventional pain management

CT Abdomen and Pelvis - General Imaging Request

1.Date of most recent office visit or other contact with physician: Don't Know Phone call with office staff Phone call with physician Don't know

  Pelvis

CT Chest, Abdomen and Pelvis Imaging Request

Don't Know. Phone call with office staff Phone call with physician Don't Know 3.Is abodminal or pelvic pain present? Yes. No Don't Know: 4.Where is the location of pain?

  Chest, Request, Imaging, Abdomen, Pelvis, Abdomen and pelvis imaging request

er emb mm/dd/yyyy - eviCore

Member requires treatment for a different condition Additional care for same condition treated in the last 60 days 2. What is the primary diagnosis?

  Yyyy, Er emb mm dd yyyy

eviCore healthcare and Cigna Integrated Oncology ...

1 eviCore healthcare and Cigna Integrated Oncology Management Program Frequently Asked Questions Who is eviCore healthcare? eviCore healthcare (eviCore) is an independent specialty medical benefits management company that provides

  Programs, Management, Frequently, Healthcare, Integrated, Oncology, Cigna, Healthcare and cigna integrated oncology, Healthcare and cigna integrated oncology management program frequently

er emb mm/dd/yyyy - eviCore

Reduced strength full range Can't move against gravity Hand function. Reduced strength full range Fingertips don't reach palm Normal strength Normal strength Raises with bent knee Unable

  Yyyy, Mm dd yyyy

eviCore Radiation Therapy 2019 Guidelines

for Radiation Oncology (ASTRO) Evidence-Based Guidelines, or supported by other acceptable peer-reviewed publications. As such, eviCore will not automatically certify a case based solely on the fact that it

Cigna Medical Coverage Policies – Radiology Cardiac Imaging

IMAGING STUDY Estimate of Effective Radiation Dose . Sestamibi myocardial perfusion study (MPI) 9-12 mSv PET myocardial perfusion study: Rubidium-82

  Imaging, Perfusion

Bone Metastases Radiation Therapy Physician Worksheet (As ...

Bone Metastases Radiation Therapy Physician Worksheet (As of 23 July 2018) 6. What is the reason for treatment? Select all that apply. Extension into viscera or a soft tissue component

Diagnostic Centers of America, Florida - Diagnostic ...

MRA Neck W W/O Contrast MIRA Pelvis W W/O Contrast MIRA Runoff MRI Pelvis Attn: Prostate W W/O (Prostate W/ 3D Reconstruction) MRI Spine Cervical W/O Contrast MRI Spine Cervical W W/O Contrast MRI Spine Lumbar W/O Contrast 74185, 73725 72197, 76377 73720 73721 73723 73218 MRI Extremity Upper Joint W/O Contrast - Shoulder, Elbow, Wrist

  Spine

MRI & MRA CPT CODES - Derry Imaging

MRI & MRA CPT CODES This is for reference only. Information is subject to change. HEAD & BRAIN BRAIN without contrast 70551 with contrast 70522 ... LUMBAR SPINE without contrast 72148 with contrast 72149 with & without contrast 72158 THORACIC SPINE without contrast 72146 with contrast 72147 ...

  Spine

Referring Physician Ordering Guide: What to Order When

Carotid or vertebral artery Dissection MRA neck without and with contrast (Dissection protocol). CTA Neck with contrast ThORacic sPiNe Indication Preferred Study Trauma CT thoracic spine without contrast. Acute neurologic deficit and CT negative: MRI without contrast www.radiax.com Toll Free: 877-997-2342

  Spine

MRI REFERENCE CHART: What to Order and How

Lumbar spine: spinal tumor, infection, syrinx, post-op spinal surgery MRI L-spine with AND without contrast Exams may vary depending on patient’s history. Orthopedic/extremity exams on reverse. 403.777.4MRI *450w= Optima MR450w 1.5T MRI Scanner

  Chart, What, Reference, Order, Spine, Mri reference chart, What to order

Prior Authorization of Advanced Diagnostic Imaging ...

Spine/Orthopedics, Neurology, and Medical/Surgical 11 Clinical Platform Family Medicine Internal Medicine Pediatrics Sports Medicine OB/GYN Cardiology Nuclear Medicine Anesthesiology Radiation Oncology ... • MRI, MRA (Magnetic Resonance …

  Advanced, Authorization, Imaging, Diagnostics, Spine, Prior, Prior authorization of advanced diagnostic imaging

Radiology - Harvard Pilgrim Health Care

• Magnetic resonance angiography (MRA) • Magnetic resonance imaging (MRI) • Nuclear medicine scans and the radionuclide used in the scan ... catheter tip for spine diagnostic/ therapeutic injection procedures (epidural or subarachnoid) (List separately in …

  Health, Care, Pilgrim, Spine, Radiology, Magnetic, Harvard, Angiography, Resonance, Magnetic resonance angiography, Harvard pilgrim health care

MRI REFERENCE CHART: What to order and how to order it

MRA EXAMS – NEURO MRA BRAIN For Circle of Willis (COW): R/O or history of aneurysm, history of TIAs MRI head AND COW Venous study (MRV) brain MRV (usually ordered with MRI brain) ... Cervical spine: MS, spinal tumor, infection, …

  Spine