Anthem/Elevance Health MRI Lumbar Spine without contrast prior authorization requirements (2026)

What Anthem/Elevance Health generally requires to approve MRI Lumbar Spine without contrast (CPT 72148), for Commercial plans. Yes. Anthem/Elevance Health generally requires prior authorization for MRI Lumbar Spine without contrast (CPT 72148).

General reference compiled from public sources, last verified 2026-06-12. This is not a coverage determination or medical advice. Always confirm current requirements with Anthem/Elevance Health before submitting.

Medical-necessity criteria Anthem/Elevance Health generally applies

Lumbar spine MRI is appropriate (per ACR Appropriateness Criteria for Low Back Pain) after at least 6 weeks of conservative management with persistent/progressive symptoms in a surgical/interventional candidate, for radiculopathy persisting more than 6 weeks despite conservative care, or when red flags (cauda equina, malignancy, infection, severe/progressive neurologic deficit) are present. Document the conservative-care trial and red-flag findings.

Situations to verify before submitting

Anthem/Elevance Health may not cover MRI Lumbar Spine without contrast in these situations. Verify against the current policy rather than assuming a denial:

  • {"text":"Routine, uncomplicated acute low back pain of less than 6 weeks duration without red flags or neurologic deficit (imaging not indicated per ACR criteria)","source":"ACR Appropriateness Criteria: Low Back Pain (2021 Update)"}

Source

Advanced imaging PA for Anthem/Elevance is managed by Carelon Medical Benefits Management. Criteria summarized from the ACR Appropriateness Criteria for Low Back Pain (2021). Source: ACR Appropriateness Criteria Low Back Pain 2021 Update (jacr.org); Carelon radiology program. Last verified 2026-06-12.

Frequently asked questions

Does Anthem/Elevance Health require prior authorization for MRI Lumbar Spine without contrast?

Yes. Anthem/Elevance Health generally requires prior authorization for MRI Lumbar Spine without contrast (CPT 72148).

What does Anthem/Elevance Health require to approve MRI Lumbar Spine without contrast?

Lumbar spine MRI is appropriate (per ACR Appropriateness Criteria for Low Back Pain) after at least 6 weeks of conservative management with persistent/progressive symptoms in a surgical/interventional candidate, for radiculopathy persisting more than 6 weeks despite conservative care, or when red flags (cauda equina, malignancy, infection, severe/progressive neurologic deficit) are present. Docume… 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 Lumbar 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.

How Praxigen worksBook a demo

Other Anthem/Elevance Health prior authorization requirements

Anterior Cervical Discectomy and FusionArthroscopic Hip Surgery for Impingement Syndrome Including Labral RepairCarpal Tunnel SurgeryCT Abdomen and Pelvis with contrastCTA Chest (e.g., pulmonary embolism)Dorsal Column (Lumbar) Neurostimulators: Trial or ImplantationKnee ArthroscopyKnee MeniscectomyLumbar Spinal FusionMRI Brain without contrastMRI Cervical Spine without contrastMRI Lower Extremity Joint without contrast

Related guides

Why was my prior authorization denied? Top reasons and how to fix eachHow to write a prior authorization appeal that cites policy