Prior authorization updates for endovascular procedures

Changes to lower extremity vascular angiography and endovascular revascularization procedures

Effective Jan. 1, 2023, we’re making the following changes to the prior authorization requirements for Lower Extremity Vascular Angiography and Endovascular Revascularization procedures:

Code removals
We’re removing the following radiology CPT® codes from the prior authorization and notification program:

• 75710
• 75716

Additions to prior authorization requirements
We’ll require prior authorization for the following endovascular revascularization CPT codes:

• 37230
• 37231

If you don’t obtain a prior authorization online before performing the service, we’ll deny your claim and you can’t bill the patient for the service.  

Diagnosis exemptions
We’ll no longer require prior authorization for endovascular revascularization with limb-threatening diagnoses and the following CPT codes: 

These diagnosis codes have been detailed in the Lower Extremity Endovascular Procedures medical policy.

Affected plans
These changes apply to UnitedHealthcare commercial plan, UnitedHealthcare® Medicare Advantage and UnitedHealthcare Community Plan members except for:

• Commercial plan members in the state of Rhode Island
• Medicare plan members in the state of Colorado
• Community plan members in the states of Colorado, Indiana, Louisiana, Nevada and Washington D.C.

Request prior authorization and notification
Use the Prior Authorization and Notification Tool on the UnitedHealthcare Provider Portal to submit your request. Please include all relevant clinical information, which will be subject to medical necessity review.

Questions?
Contact Provider Services at 866-416-6594 if you have any questions.

CPT® is a registered trademark of the American Medical Association.

PCA-1-22-02143-VC-News