Prior Auth Required

72158 - Magnetic resonance (eg, proton) imaging, spinal canal and contents, without contrast material, followed by Prior Authorization Required Only if POS is 22 (On Campus-Outpatient Hospital)

This procedure appears on the selected insurer prior authorization source.

Prior authorizationPrior Auth Required
Procedure / ServiceMagnetic resonance (eg, proton) imaging, spinal canal and contents, without contrast material, followed by Prior Authorization Required Only if POS is 22 (On Campus-Outpatient Hospital)
Procedure / Service Description

Code NAME/DESCRIPTION COMMENTS - 72157 Magnetic resonance (eg, proton) imaging, spinal canal and contents, without contrast material, followed by Prior Authorization Required Only if POS is 22 (On Campus-Outpatient Hospital) contrast material(s) and further sequences; thoracic 72158 Magnetic resonance (eg, proton) imaging, spinal canal and contents, without contrast material, followed by Prior Authorization Required Only if POS is 22 (On Campus-Outpatient Hospital) contrast material(s) and further sequences; lumbar 72195 Magnetic resonance (eg, proton) imaging, pelvis; without contrast material(s) Prior Authorization Required Only if POS is 22 (On Campus-Outpatient Hospital)

Likely documents
  • Confirm benefit details
  • Submit clinical notes if requested by the plan
Next actions
  • Confirm the current plan policy before submission.
  • Use the insurer authorization workflow for this listed code.