Effective June 1, 2022, procedure codes will be updated for the radiology notification and prior authorization and cardiology prior authorization programs for UnitedHealthcare Community Plan, Commercial and Exchange.
These requirements do not apply to advanced imaging services provided in an:
Radiology notification and prior authorization code updates
Claims with dates of service on or after June 1, 2022 that are subject to the following CPT codes are being added to the Radiology notification and prior authorization list.
| CPT code | Description |
|---|---|
| New codes | |
0697T |
Quantitative magnetic resonance for analysis of tissue composition (e.g., fat, iron, water content), including multiparametric data acquisition, data preparation and transmission, interpretation and report, obtained without diagnostic MRI examination of the same anatomy (e.g., organ, gland, tissue, target structure) during the same session; multiple organs |
0698T |
Quantitative magnetic resonance for analysis of tissue composition (e.g., fat, iron, water content), including multiparametric data acquisition, data preparation and transmission, interpretation and report, obtained with diagnostic MRI examination of the same anatomy (e.g., organ, gland, tissue, target structure); multiple organs (List separately in addition to code for primary procedure) |
0710T |
Noninvasive arterial plaque analysis using software processing of data from non-coronary computerized tomography angiography; including data preparation and transmission, quantification of the structure and composition of the vessel wall and assessment for lipid-rich necrotic core plaque to assess atherosclerotic plaque stability, data review, interpretation and report |
0711T |
Noninvasive arterial plaque analysis using software processing of data from non-coronary computerized tomography angiography; data preparation and transmission |
0712T |
Noninvasive arterial plaque analysis using software processing of data from non-coronary computerized tomography angiography; quantification of the structure and composition of the vessel wall and assessment for lipid-rich necrotic core plaque to assess atherosclerotic plaque stability |
0713T |
Noninvasive arterial plaque analysis using software processing of data from non-coronary computerized tomography angiography; data review, interpretation and report |
Cardiology prior authorization code updates
Claims with dates of service on or after June 1, 2022 that are subject to the following CPT codes are being added to the Cardiology prior authorization list.
| CPT code | Description |
|---|---|
| New codes | |
93319 |
3D echocardiographic imaging and postprocessing during transesophageal echocardiography, or during transthoracic echocardiography for congenital cardiac anomalies, for the assessment of cardiac structure(s) (e.g., cardiac chambers and valves, left atrial appendage, interatrial septum, interventricular septum) and function, when performed (List separately in addition to code for echocardiographic imaging) |
Questions?
If you are unsure if prior authorization is required for a patient or service, use our Prior Authorization and Notification Tool.
For complete details on radiology and cardiology policies and protocol, refer to the current UnitedHealthcare administrative guide.