Anthem/Elevance Health MRI Cervical Spine without contrast prior authorization requirements (2026)
What Anthem/Elevance Health generally requires to approve MRI Cervical Spine without contrast (CPT 72141), for Commercial plans. Yes. Anthem/Elevance Health generally requires prior authorization for MRI Cervical Spine without contrast (CPT 72141).
Medical-necessity criteria Anthem/Elevance Health generally applies
Cervical spine MRI is appropriate (per ACR Appropriateness Criteria for Cervical Neck Pain or Cervical Radiculopathy) for new or increasing cervical radiculopathy, suspected myelopathy, or suspected infection or known malignancy (MRI without and with contrast). For neck pain without red flags or radiculopathy, radiographs are the appropriate initial imaging.
Situations to verify before submitting
Anthem/Elevance Health may not cover MRI Cervical Spine without contrast in these situations. Verify against the current policy rather than assuming a denial:
- {"text":"Uncomplicated mechanical neck pain without radiculopathy, myelopathy, or red flags (radiographs are the appropriate initial imaging per ACR criteria)","source":"ACR Appropriateness Criteria: Cervical Neck Pain or Cervical Radiculopathy (2024 Update)"}
Source
Advanced imaging PA for Anthem/Elevance is managed by Carelon. Criteria summarized from ACR Appropriateness Criteria Cervical Neck Pain or Cervical Radiculopathy (2024). Source: jacr.org; Carelon radiology program. Last verified 2026-06-12.
Frequently asked questions
Does Anthem/Elevance Health require prior authorization for MRI Cervical Spine without contrast?
Yes. Anthem/Elevance Health generally requires prior authorization for MRI Cervical Spine without contrast (CPT 72141).
What does Anthem/Elevance Health require to approve MRI Cervical Spine without contrast?
Cervical spine MRI is appropriate (per ACR Appropriateness Criteria for Cervical Neck Pain or Cervical Radiculopathy) for new or increasing cervical radiculopathy, suspected myelopathy, or suspected infection or known malignancy (MRI without and with contrast). For neck pain without red flags or radiculopathy, radiographs are the appropriate initial imaging. Always confirm against the current Anthem/Elevance Health policy.
How long does a Anthem/Elevance Health prior authorization take?
Turnaround varies by plan and submission method. Check the Anthem/Elevance Health portal for current timeframes.
Submitting MRI Cervical Spine without contrast to Anthem/Elevance Health?
Praxigen checks your clinical note against these criteria before you submit and drafts a policy-cited appeal if it is denied. You review and submit; nothing is sent automatically.