July 01, 2022

Exchange: Prior authorization no longer required for certain CPT codes

As of Oct. 1, 2022, prior authorization and notification is no longer required for the following CPT codes:

Arthroplasty

CPT code Description Applicable states
SBRT/SRS
27122 Acetabuloplasty; resection, femoral head (eg, Girdlestone procedure) Remove Prior Authorization AL, AZ, FL, GA, IL, LA, MD, MI, NC, OK, TN, TX, VA, WA

Genetic and Molecular Testing

CPT code Description Applicable states
SBRT/SRS
0168U Fetal aneuploidy (trisomy 21, 18, and 13) DNA sequence analysis of selected regions using maternal plasma without fetal fraction cutoff, algorithm reported as a risk score for each trisomy Remove Prior Authorization AL, AZ, FL, GA, IL, LA, MD, MI, NC, OK, TN, TX, VA, WA

Orthognathic Surgery

CPT code Description Applicable states
SBRT/SRS
21116 Injection procedure for temporomandibular joint arthrography Remove Prior Authorization AL, AZ, FL, GA, IL, LA, MD, MI, NC, OK, TN, TX, VA, WA

Injectables

CPT code Description Applicable states
SBRT/SRS
S1091 Stent, noncoronary, temporary, with delivery system (Propel) Remove Prior Authorization AL, AZ, FL, GA, IL, LA, MD, MI, NC, OK, TN, TX, VA, WA

Chelation Therapy 

CPT code Description Applicable states
SBRT/SRS
J0895 Injection, deferoxamine mesylate, 500mg Remove Prior Authorization AL, AZ, FL, GA, IL, LA, MD, MI, NC, OK, TN, TX, VA, WA

Questions?
Please contact UnitedHealthcare Provider Services at 877-842-3210, TTY/RTT 711, 7 a.m.–5 p.m. CT, Monday–Friday.

CPT® is a registered trademark of the American Medical Association.
PCA-1-22-02075-E&INews