Radiology Procedures Requiring Pr ior Authorization for ...
Effective Date: June 1, 2021 Instructions for Use . Table of Contents Page Coverage Rationale ... • Magnetic Resonance Imaging (MRI) and Computed Tomography (CT) Scan – Site of Service ... MRI Head w/o contrast . 04/15/1999 : MRI . 70552 : MRI Head w/ contrast . 04/15/1999 : MRI … ................
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