Radiology and cardiology prior authorization updates

Effective Jun. 1, 2021, we are updating the procedure code lists for the radiology and cardiology notification and prior authorization programs for UnitedHealthcare Community Plan, Medicare Advantage, commercial and Exchange.

These updates are based on code changes made by the American Medical Association (AMA).

• The following CPT® codes are being added to the notification and prior authorization list:
  • Radiology and cardiology program procedure code changes
• For current listing of CPT codes that require notification and prior authorization, go to:
  • UHCprovider.com/radiology
  • UHCprovider.com/cardiology

These requirements do not apply to advanced imaging or cardiology services provided in an:

• Emergency room
• Urgent care center
• Observation unit
• Inpatient stay (except for electrophysiology implants)

For complete details on the radiology or cardiology protocol, refer to the current UnitedHealthcare Administrative Guide.