Prior Authorizations for MUGA Scan and Myocardial Perfusion Imaging

Prior Authorizations for MUGA Scan and Myocardial Perfusion Imaging

02/17/2020

National Imaging Associates (NIA) Magellan Healthcare manages radiology prior authorizations on behalf of BlueCross BlueShield of South Carolina and BlueChoice HealthPlan. Effective May 1, 2020, prior authorizations for CPT-4 codes related to multiple gated acquisition (MUGA) scans and myocardial perfusion imaging are required for all groups that currently have the NIA radiology program. We recommend that you verify eligibility and benefits, and prior authorization requirements for all services rendered using My Insurance Manager (MIM) or the Voice Response Unit (VRU) at each patient visit.

Below is a list of the codes for the services:

Authorized CPT Code DescriptionAllowable Billed Groupings
78472MUGA Scan 78472, 78473, 78494, 78496
78451Myocardial Perfusion Imaging – Nuclear Cardiology Study 78451, 78452, 78453, 78454, 78466, 78468, 78469, 78481, 78483, 78499

You can learn more about prior authorization requirements for cardiac and other radiology services by viewing the Cardiac Services Checklist, Cardiac Services Tip Sheet and more in the Prior Authorization section of www.BlueChoiceSC.com. If you have questions about this bulletin, please send an email to provider.education@bcbssc.com or submit your question using the Provider Education Contact Form.