As of December 1,2021 the following codes will be added to the radiology prior authorization list. These codes will require an authorization for DOS 12/01/2021 and thereafter.
The prior authorization for these codes WILL NOT APPLY TO The following situations: if the advanced imaging is done in-
- Emergency room
- Urgent care center
- Observation unit
- Inpatient stay
In case you missed it:
In June 2021, UHC also added more Radiology and Cardiology codes on the Prior Authorization List. These codes apply to UnitedHealthCare Community Plan, Medicare Advantage, commercial and exchange Plans
For complete details on the radiology protocol, refer to the current UnitedHealthcare Administrative Guide
Find this type of information useful? Follow my blog for more insurance payer updates, medical coding and medical billing guideline changes, reimbursement and medical policy updates.
RECENT BLOG POSTS:
- MVP Health Plans: reimbursement of sick E&M codes billed w/preventative codes -05/01/23
- Michigan Medicaid: reimburses for Doula Services-01/01/23
- UHC NY Community Plan Referral requirement change-effective immediately
- UHC Oxford- updated Prior Auth changes 01/01/2023
- UHC Exchange Plans: diabetes medications coverage.