On Sept. 1, UnitedHealthcare is set to begin a two-phased approach to eliminate prior authorization requirements for several procedure codes, including 12 cardiology-related codes. The code removals will account for almost 20 percent of its overall prior authorization volume.
On Sept. 1 and Nov. 1, codes will be eliminated for UnitedHealthcare Medicare Advantage, UnitedHealthcare commercial, UnitedHealthcare Oxford and UnitedHealthcare Individual Exchange plans. On Nov. 1, codes will be eliminated for the UnitedHealthcare Community Plan as well.
Here are the 12 cardiology codes that will be eliminated from prior authorization requirements, according to lists published on UHC'swebsite:
United commercial plan codes:
93303: Complete transthoracic echocardiography for congenital cardiac anomalies
93304: Transthoracic echocardiography for congenital cardiac anomalies; follow-up or limited study
United Oxford plan codes:
36483: Endovascular ablation therapy of incompetent extremity veins
92960: Elective cardioversion
93312: Transesophageal echocardiography
93660: Evaluation of a heart function using a tilt table
G0257: Unscheduled or emergency dialysis treatment for an ESRD patient in a hospital outpatient department that is not certified as an ESRD facility
G0491: Dialysis procedure at a Medicare-certified ESRD facility for acute kidney injury without end-stage renal disease
G0492: Dialysis 1 evaluation physician kidney injury without end-stage renal disease
United individual exchange plan codes:
None
United Medicare Advantage plan codes:
None
United community plan codes:
93303: Complete transthoracic echocardiography for congenital cardiac anomalies
93304: Transthoracic echocardiography for congenital cardiac anomalies; follow-up or limited study
93306: Performing and interpreting of a complete transthoracic echocardiogram
93307: Echocardiography transthoracic, real-time with image documentation
93308: Echocardiography transthoracic, real-time with image documentation, includes M-mode recording when performed