On Sept. 1, UnitedHealthcare is set to begin a two-phased approach to eliminate prior authorization requirements for several procedure codes, including four spine-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 four spinal surgery codes that will be eliminated from prior authorization requirements, according to lists published on UHC's website:
United commercial plan codes
22864: Removal disc arthroplasty anterior 1 interspace cervical
22865: Removal disc arthroplasty anterior 1 interspace lumbar
0095T: Removal total disc arthroscopy anterior approach, each additional interspace, cervical
0164T: Removal total disc arthroscopy anterior approach, each additional interspace, lumbar
United Oxford plan codes
22864: Removal disc arthroplasty anterior 1 interspace cervical
22865: Removal disc arthroplasty anterior 1 interspace lumbar
0095T: Removal total disc arthroscopy anterior approach, each additional interspace, cervical
0164T: Removal total disc arthroscopy anterior approach, each additional interspace, lumbar
United individual exchange plan codes
22864: Removal disc arthroplasty anterior 1 interspace cervical
22865: Removal disc arthroplasty anterior 1 interspace lumbar
0095T: Removal total disc arthroscopy anterior approach, each additional interspace, cervical
0164T: Removal total disc arthroscopy anterior approach, each additional interspace, lumbar
United Medicare Advantage plan codes
22864: Removal disc arthroplasty anterior 1 interspace cervical
22865: Removal disc arthroplasty anterior 1 interspace lumbar
United community plan codes
22864: Removal disc arthroplasty anterior 1 interspace cervical
22865: Removal disc arthroplasty anterior 1 interspace lumbar
0095T: Removal total disc arthroscopy anterior approach, each additional interspace, cervical
0164T: Removal total disc arthroscopy anterior approach, each additional interspace, lumbar