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.