UnitedHealthcare removes 4 spinal surgery codes in effort to cut prior authorization by 20%

Spine

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

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