Prior authorization approved

This letter confirms that the prior-authorization request submitted on behalf of Conor Brennan (member ID CIG-117044298) for CT Colonography (Virtual Colonoscopy) — high-risk screening has been approved.

The determination was rendered under Magnetic Resonance Imaging — Lumbar Spine (Anthem Medical Policy RAD.00029, effective 2026-01-01). All 5 medical-necessity criteria were evaluated against the submitted clinical evidence.

Clinical rationale: High-risk screening criteria met; prior optical colonoscopy incomplete; CTC is appropriate alternative.