Prior Auth Required

72197 - Magnetic resonance (eg, proton) imaging, Prior Authorization Required Advanced Imaging Submit online review with Carelon at

This procedure appears on the selected insurer prior authorization source.

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Prior authorizationPrior Auth Required
Procedure / ServiceMagnetic resonance (eg, proton) imaging, Prior Authorization Required Advanced Imaging Submit online review with Carelon at
Procedure / Service Description

Code Description Plan Review Requirement Reviewed For Records Request - and site of care delivery. 72197 Magnetic resonance (eg, proton) imaging, Prior Authorization Required Advanced Imaging Submit online review with Carelon at pelvis; without contrast material(s), www.providerportal.com. For Site of Care, followed by contrast material(s) and further include history and physical, with results

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.