Why did Anthem deny my MRI?

Usually because a radiology-benefit reviewer decided it wasn't yet medically necessary or that prior authorization was missing. Documentation that you already tried conservative treatment is the key to overturning it.

Guides · Anthem · appeals · Updated July 2026

How to appeal an Anthem MRI or imaging denial

Anthem (Elevance) frequently denies advanced imaging like MRIs and CT scans on medical-necessity or prior-authorization grounds, often requiring you to try conservative treatment first.

Why Anthem denies this

Anthem routes imaging requests through radiology-benefit management criteria. Denials commonly cite code 50 (not medically necessary) or 197 (authorization missing). If your doctor ordered the scan after conservative treatment failed, the denial is vulnerable.

What wins the appeal

Your physician's note documenting the symptoms, the conservative treatment already tried (physical therapy, medication, time), and why imaging is now necessary. If it's an authorization denial, request retro-authorization. File within 180 days (65 for Medicare Advantage).

Your deadline

Depends on your plan type: 180 days for most employer and marketplace plans, 120 for Original Medicare, ~90 for Medicaid, and only 65 for Medicare Advantage. Set it before you do anything else.

Don't fight it alone — and don't miss the deadline

AppealClock translates your denial, drafts your appeal letter, and watches every deadline so you can't miss it. Free, no account, your medical details never leave your device.

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Common questions

Why did Anthem deny my MRI?: Usually because a radiology-benefit reviewer decided it wasn't yet medically necessary or that prior authorization was missing. Documentation that you already tried conservative treatment is the key to overturning it.