Oxford Health Plans MRI Lumbar Spine with contrast prior authorization requirements (2026)
What Oxford Health Plans generally requires to approve MRI Lumbar Spine with contrast (CPT 72149), for Commercial plans. Yes. Oxford Health Plans generally requires prior authorization for MRI Lumbar Spine with contrast (CPT 72149).
Medical-necessity criteria Oxford Health Plans generally applies
[NEEDS CLINICAL SPOT-CHECK] Prior authorization required; Oxford (a UnitedHealthcare company) precertifies advanced outpatient radiology (CT, MRI, MRA) through eviCore. Spine MRI/CT require precertification per the Oxford radiology precertification list; criteria follow eviCore Spine Imaging Guidelines (failed conservative trial / red-flag bypass).
How to submit
- Method: eviCore
Sources & verification
- BindingSource — Oxford radiology procedures requiring precertification (eviCore) · effective 2023-01-01.View
Binding = the payer's own policy. Proxy = a public, evidence-based clinical guideline the payer mirrors. Portal-only = the binding criteria are confirmed in the administrator's portal. Always confirm against the payer for the member's specific plan. Last verified 2026-06-28.
Frequently asked questions
Does Oxford Health Plans require prior authorization for MRI Lumbar Spine with contrast?
Yes. Oxford Health Plans generally requires prior authorization for MRI Lumbar Spine with contrast (CPT 72149).
What does Oxford Health Plans require to approve MRI Lumbar Spine with contrast?
[NEEDS CLINICAL SPOT-CHECK] Prior authorization required; Oxford (a UnitedHealthcare company) precertifies advanced outpatient radiology (CT, MRI, MRA) through eviCore. Spine MRI/CT require precertification per the Oxford radiology precertification list; criteria follow eviCore Spine Imaging Guidelines (failed conservative trial / red-flag bypass). Always confirm against the current Oxford Health Plans policy.
How long does a Oxford Health Plans prior authorization take?
Turnaround varies by plan and submission method. Check the Oxford Health Plans portal for current timeframes.
Submitting MRI Lumbar Spine with contrast to Oxford Health Plans?
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.