Applies to:
All plans
Definition:
Priority Health covers an annual CT scan for lung cancer as a preventive benefit for members between 50-80 years old. Specific age and smoking status criteria must be met.
Preventive lung cancer CT scan authorization
Patients must meet eviCore healthcare criteria for the service to be covered as preventive.
Participating providers request authorization by using our Auth Request tool to enter the CPT code. You'll be transferred to eviCore healthcare to complete your request.
Non-participating providers:
- In-state providers should call eviCore healthcare for authorization: 844.303.8456.
- Out-of-state providers should call us to check benefits and authorizations at 833.300.3628.
Lung cancer screening billing
For the preventive screening: Bill code 71271
For counseling: Bill code G0296