eviCore MRI Cervical Spine without and with contrast prior authorization requirements (2026)
What eviCore generally requires to approve MRI Cervical Spine without and with contrast (CPT 72156), for Commercial plans. Yes. eviCore generally requires prior authorization for MRI Cervical Spine without and with contrast (CPT 72156).
Medical-necessity criteria eviCore generally applies
Contrast-enhanced cervical spine MRI (without and with gadolinium) is appropriate for: suspected or known spinal infection; suspected neoplasm or metastatic/leptomeningeal disease; demyelinating disease (e.g. multiple sclerosis) evaluation; or the post-operative cervical spine to distinguish recurrent disc from scar. Not indicated for uncomplicated axial neck pain or first-presentation radiculopathy without red flags (use non-contrast).
Source
Summarized from eviCore Spine Imaging Guidelines (eff. 2025-02-14) and ACR Appropriateness Criteria. Sources: and https://www.acr.org/Clinical-Resources/Clinical-Tools-and-Reference/Appropriateness-Criteria View the source policy. Last verified 2026-06-13.
Frequently asked questions
Does eviCore require prior authorization for MRI Cervical Spine without and with contrast?
Yes. eviCore generally requires prior authorization for MRI Cervical Spine without and with contrast (CPT 72156).
What does eviCore require to approve MRI Cervical Spine without and with contrast?
Contrast-enhanced cervical spine MRI (without and with gadolinium) is appropriate for: suspected or known spinal infection; suspected neoplasm or metastatic/leptomeningeal disease; demyelinating disease (e.g. multiple sclerosis) evaluation; or the post-operative cervical spine to distinguish recurrent disc from scar. Not indicated for uncomplicated axial neck pain or first-presentation radiculopat… Always confirm against the current eviCore policy.
How long does a eviCore prior authorization take?
Turnaround varies by plan and submission method. Check the eviCore portal for current timeframes.
Submitting MRI Cervical Spine without and with contrast to eviCore?
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.