Support documentation for coronary angiography prior authorization requests

As part of our ongoing quality improvement efforts, we want you to know that some requests for coronary angiography will require documentation to substantiate the attestations that support the clinical appropriateness of the request. This documentation should be uploaded during the intake process.

When requested, providers must submit such documentation from the patient’s medical record. If medical necessity is not supported through the documents submitted, the request may be denied as there is not enough information to establish if the request is medically necessary. Documentation is limited to what has been asserted via the prior authorization review attestations.

If the request is denied as not medically necessary, providers can participate in a peer-to-peer discussion with a Carelon Medical Benefits Management, Inc. physician reviewer.

For more information on our guidelines, visit guidelines.carelonmedicalbenefitsmanagement.com and select Cardiology.

Contact us

Availity Chat with Payer is available during normal business hours. Get answers to your questions about eligibility, benefits, authorizations, claims status, and more. To access Availity Essentials, go to Availity.com and select the appropriate payer space tile from the drop-down. Then, select Chat with Payer and complete the pre-chat form to start your chat.

For additional support, visit the Contact Us section at the bottom of our provider website for the appropriate contact.

With your help, we can continually build towards a future of shared success.