On Sept. 1, UnitedHealthcare is set to begin a two-phased approach to eliminate prior authorization requirements for several procedure codes, including three gastroenterology-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.
These cuts come as UnitedHealthcare has faced blowback from gastroenterologists for adding prior authorization requirements for patients undergoing surveillance colonoscopies.
Here are the three gastroenterology codes that will be eliminated from prior authorization requirements, according to lists published on UHC's website:
United commercial plan codes
None
United Oxford plan codes
91040: Esophageal balloon distension study with provocation
91120: Rectal sensation, tone and compliance test
91122: Anorectal manometry
United individual exchange plan codes
None
United Medicare Advantage plan codes
None
United community plan codes
None