CT scan denied: how to appeal
The insurer says the CT was not medically necessary or not authorized. Specific clinical indication matching the policy.
Why this denial happens
- Alternative imaging not tried
- Indication not on policy list
What overturns it
- Specific clinical indication matching the policy
- Specialist letter
Evidence checklist
- ✓Office notes
- ✓Prior imaging
- ✓Specialist letter
ER CT scans are typically protected under emergency benefits.
Draft an appeal for a "CT scan" denial
Free analysis identifies the cited policy and missing evidence. Then a finished letter.
FAQ
What does "CT scan denied" mean on a denial letter?+
The insurer says the CT was not medically necessary or not authorized.
How long do I have to appeal?+
180 days from the date of denial for ERISA group plans and ACA marketplace plans. 60 days for Medicare Advantage. Check the denial letter for your specific deadline.
What is the success rate for this kind of appeal?+
Outcomes vary, but medical-necessity and step-therapy appeals overturn at meaningful rates when the appeal cites the insurer's own policy and the chart documents the required criteria.
Other denial reasons
Not legal or medical advice. This page is a self-help resource. You make your own decisions. Strip personal identifiers (name, date of birth, address, member ID) from any document before uploading or sharing. The information here summarizes commonly-published payer policies and federal rules; confirm against your specific plan document and the current denial letter before acting.