CT scan denied by insurance — how to appeal

About CT scan

CT scan denials usually involve either prior authorization not being obtained or a medical-necessity determination. The appeal centers on the ordering provider's clinical reasoning and citations to imaging appropriateness criteria.

Common reasons CT scan gets denied

• Prior authorization not obtained
• Not medically necessary determination
• Coverage criteria not met

Evidence that helps overturn a CT scan denial

• Clinical indication letter from ordering provider
• Documentation of preceding workup
• Imaging appropriateness criteria citation

Recommended approach

For most CT scan denials, our triage will recommend the Strong Appeal ($249) tier. We prepare a professionally-structured appeal that addresses the specific denial reason, cites the relevant clinical evidence, and meets your insurer’s appeal-rights deadlines. Treatment cost exposure: typically $500–$3,000.

What to do next

1. Find your denial letter (or EOB) and check the appeal deadline.
2. Upload it to InsureDefense for a free triage — no payment required to see the assessment.
3. If you choose to proceed, you’ll receive a draft within 24 hours (12 hours for urgent cases).
4. Submit the appeal to your insurer using the fax / portal / mailing address we provide.
5. Track the insurer’s response using our 14/30/45-day follow-up reminders.

Upload your CT scan denial See pricing