FLASH: Removal of Prior Authorization for Ultrasound Imaging Tests and Recommendations for the Global IV Contrast Shortage

Removal of Prior Authorization for Ultrasound Imaging Tests

Health Alliance™ performs an annual review of all prior authorization required services for utilization and value. We have some great news to share with our provider community. General and obstetric ultrasound imaging will no longer require prior authorization effective August 1, 2022 and will be removed from the Health Alliance Standard Prior Authorization list. Some limited specialty ultrasounds will continue to require prior authorization.** Please continue to submit requests for other prior authorization such as advancing imaging which includes CT, MRI, and PET, through our partner, eviCore healthcare.

All obstetric ultrasounds are included in the removal of prior authorization change. We value the excellent care you provide our members and in the absence of prior authorization, we encourage you to continue following the current standard of care guidelines for obstetric ultrasound when making decisions about the appropriate use of ultrasounds in prenatal care:

• American College of Obstetricians and Gynecologist (ACOG) practice bulletin for Ultrasound in Pregnancy
• The collaborative ultrasound practice guideline issued by the American Institute of Ultrasound in Medicine (AIUM), Society for Maternal-Fetal Medicine (SMFM), American College of Radiology (ACR), Society of Radiologists in Ultrasound (SRU), and ACOG.

**Please login to provider.healthalliance.org to perform a member plan specific search whether specific CPT and HCPCS codes require Prior Authorization or please contact your provider specialist

Recommendations for the Global IV Contrast Shortage

Health Alliance is aware of the current global shortage of iodinated contrast media and are aligned with the recent recommendations from the American College of Radiology Committee on Drugs and Contrast Media, referenced below. In addition to prioritizing and wisely utilizing the existing supplies, providers should consider utilizing appropriate alternative imaging studies to address the various clinical scenarios. These might include non-contrast CT, MRI with or without gadolinium-based contrast media, ultrasound with or without ultrasound contrast agents, nuclear medicine, or PET/CT. Please refer to the applicable eviCore Imaging Guidelines for the indicated alternative imaging studies as needed.  For the next eight weeks while these shortages are ongoing, eviCore will approve alternative imaging where appropriate and in scenarios where contrast media is not available.

Statement from the ACR Committee on Drugs and Contrast Media. May 5, 2022. https://www.acr.org/Advocacy-and-Economics/ACR-Position-Statements/Contrast-Media-Shortage

Please visit the Provider’s Hub at https://www.evicore.com/ for resources such as clinical guidelines and support.