Carelon Clinical Appropriateness Guidelines for Advanced Imaging/Cardiology
ADVANCED IMAGING
Abdomen and Pelvis Imaging
OPEN THE GUIDELINES FOR IMAGING OF THE ABDOMEN AND PELVIS EFFECTIVE MARCH 13, 2022
Brain Imaging
OPEN THE GUIDELINES FOR IMAGING OF THE BRAIN EFFECTIVE SEPTEMBER 1, 2022
Cardiac Imaging
OPEN THE GUIDELINES FOR IMAGING OF THE HEART EFFECTIVE MARCH 13, 2022
COMING SOON CARDIAC IMAGING GUIDELINES EFFECTIVE NOVEMBER 6, 2022
Chest Imaging
OPEN THE GUIDELINES FOR IMAGING OF THE CHEST EFFECTIVE MARCH 13, 2022
Extremity Imaging
OPEN THE GUIDELINES FOR IMAGING OF THE EXTREMITIES EFFECTIVE SEPTEMBER 11, 2022
Head and Neck Imaging
OPEN THE GUIDELINES FOR IMAGING OF THE HEAD AND NECK EFFECTIVE MARCH 13, 2022
Oncologic Imaging
OPEN THE GUIDELINES FOR ONCOLOGIC IMAGING EFFECTIVE SEPTEMBER 1, 2022
COMING SOON ONCOLOGIC IMAGING GUIDELINES EFFECTIVE NOVEMBER 6, 2022
Spine Imaging
OPEN THE GUIDELINES FOR IMAGING OF THE SPINE EFFECTIVE SEPTEMBER 11, 2022
Vascular Imaging
OPEN THE GUIDELINES FOR VASCULAR IMAGING EFFECTIVE SEPTEMBER 11, 2022
NUCLEAR IMAGING
Nuclear Medicine
OPEN THE GUIDELINES FOR NUCLEAR MEDICINE IMAGING EFFECTIVE SEPTEMBER 11, 2022
SPECT
OPEN THE GUIDELINES FOR SPECT IMAGING EFFECTIVE SEPTEMBER 11, 2022
OTHER IMAGING AND PROCEDURAL GUIDELINES
Low-field MRI
OPEN THE GUIDELINES FOR LOW-FIELD MRI EFFECTIVE JANUARY 1, 2021
MR-guided Procedures
OPEN THE GUIDELINES FOR MR-GUIDED PROCEDURES EFFECTIVE JANUARY 1, 2021
CPT code lists
To access the current CPT code list, please refer to the appropriate BCBS health plan provider page
- Illinois Commercial
- Montana
- New Mexico Commercial
- Blue Cross Centennial CommunitySM (New Mexico Medicaid)
- Oklahoma (look for the link to “Preauthorization Requirements Lists”)
- Texas
Archived Guidelines
Please note archived guidelines effective March 14, 2021 replaced January 1, 2021 versions. Clinical content did not change.
Abdominal and Pelvic Imaging
- Abdominal and Pelvic Imaging effective November 7, 2021 – March 12, 2022
- Abdominal and Pelvic Imaging effective March 14 – November 6, 2021
- Abdominal and Pelvic Imaging effective January 1 – March 13, 2021
Brain Imaging
- Brain Imaging effective March 13, 2022 – August 31, 2022
- Brain Imaging effective March 14, 2021 – March 12, 2022
- Brain Imaging effective January 1 – March 13, 2021
Cardiac Imaging
- Cardiac Imaging effective January 1, 2022 – March 12, 2022
- Cardiac Imaging effective November 7, 2021 – December 31, 2021
- Cardiac Imaging effective September 12, 2021 – November 6, 2021
- Cardiac Imaging effective March 14, 2021 – September 11, 2021
- Cardiac Imaging effective January 1 – March 13, 2021
Chest Imaging
- Chest Imaging effective November 7, 2021 – March 12, 2022
- Chest Imaging effective March 14 – November 6, 2021
- Chest Imaging effective January 1 – March 13, 2021
Extremity Imaging
- Extremity Imaging effective September 12, 2021 – September 10, 2022
- Extremity Imaging effective March 14 – September 11, 2021
- Extremity Imaging effective January 1 – March 13, 2021
Head and Neck Imaging
- Head and Neck Imaging effective November 7, 2021 – March 12, 2022
- Head and Neck Imaging effective March 14- November 6, 2021
- Head and Neck Imaging effective January 1 – March 13, 2021
Oncologic Imaging
- Oncologic Imaging effective March 13, 2022 – August 31, 2022
- Oncologic Imaging effective November 7, 2021 – March 12, 2022
- Oncologic Imaging effective May 1 – November 6, 2021
- Oncologic Imaging effective March 14 – April 30, 2021
- Oncologic Imaging effective January 1 – March 13, 2021
Spine Imaging
- Spine Imaging effective September 12, 2021 – September 10, 2022
- Spine Imaging effective March 14 – September 11, 2021
- Spine Imaging effective January 1 – March 13, 2021
Vascular Imaging
- Vascular Imaging effective June 12 – September 10, 2022
- Vascular Imaging effective September 12, 2021 – June 11, 2022
- Vascular Imaging effective March 14 – September 11, 2021
- Vascular Imaging effective January 1 – March 13, 2021
Nuclear Medicine
- Nuclear Medicine effective June 12 – September 10, 2022
- Nuclear Medicine effective September 12, 2021 – June 11, 2022
- Nuclear Medicine effective January 1 – September 11, 2021