June 01, 2022

New codes added to prior authorization list for Commercial plans

Starting Sept. 1, 2022, we’re adding additional codes to the prior authorization list for UnitedHealthcare Commercial plans, including:

  • River Valley
  • Neighborhood Health Partnership
  • UHC West
  • MidAtlantic Health Plans
  • Oxford HealthPlan
  • UnitedHealthcare Individual and Family Plans (IFP)  

Codes added to prior authorization list effective Sept. 1, 2022
The following codes will be added to the prior authorization list effective Sept. 1, 2022.

Breast Reconstruction (Non-Mastectomy)

CPT® code  Description Plan Impacted

15771

Grafting of autologous fat harvested by liposuction technique to trunk, breasts, scalp, arms, and/or legs; 50 cc or less injectate

Commercial, IFP

Cosmetic & Reconstructive

CPT® code  Description

15769

Grafting of autologous soft tissue, other, harvested by direct excision (eg, fat, dermis, fascia)

15773

Grafting of autologous fat harvested by liposuction technique to face, eyelids, mouth, neck, ears, orbits, genitalia, hands, and/or feet; 25 cc or less injectate

Codes added to prior authorization list effective Nov. 1, 2022
The following codes will be added to the prior authorization list effective Nov. 1, 2022.

Pain Management & Injections

CPT code  Description  Plan Impacted

64450

Injection(s), anesthetic agent(s) and/or steroid; other peripheral nerve or branch

Commercial, Oxford

How to submit prior authorization
Submit your prior authorization request on the UnitedHealthcare Provider Portal using your One Healthcare ID and the Prior Authorization and Notification tool.

Questions?
For more information, review the following online resources:

PCA-1-22-01651-Clinical-News