Global Shortage of Iodinated Contrast Media

Impact on Imaging Study Authorizations

Due to the current shortage of CT contrast, EviCore medical reviewers are following guidance regarding the appropriate alternative imaging studies, according to our evidence-based clinical guidelines for individual case scenarios. EviCore is also aligned with the recent recommendations from the American College of Radiology Committee on Drugs and Contrast Media.

In addition to prioritizing and wisely utilizing existing contrast agent supplies, providers may consider alternative imaging studies, if appropriate for a patient’s individual clinical scenario, including:

• Non-contrast CT
• MRI with or without gadolinium-based contrast media
• Ultrasound with or without ultrasound contrast agents
• Nuclear medicine studies

Other important considerations:

• Our evidence-based guidelines already list alternative imaging options when CT with contrast cannot be performed due to contrast allergies, poor renal function or urgent/emergent settings due to availability. In most instances the alternative study is a non-contrast CT. There may be a few situations where MRI is indicated if a contrasted CT cannot be performed.
• Except where contrast is explicitly indicated by the guidelines, EviCore will approve non-contrast CT studies upon request when clinically appropriate, rather than creating an alternative recommendation for a higher level of contrast, which may not be possible given the shortage.
• MRI will not be routinely authorized when contrasted CT cannot be performed. However, MRI may be appropriate in those cases where the EviCore evidence-based guidelines explicitly support approval for MRI if contrasted CT is not clinically supported, or if clinical questions remain after a non-contrast CT study, which would affect patient management.

If you have further questions, please contact your Regional Provider Engagement Manager.