skip to Main Content

United Healthcare January 2018 Medical Policy Updates

Click here to view the United Healthcare Medical Policy Updates »

ANNUAL CPT® AND HCPCS CODE UPDATES

  • 17-Alpha-Hydroxyprogesterone Caproate (Makena™ and 17P) – Effective Jan. 1, 2018
  • Abnormal Uterine Bleeding and Uterine Fibroids – Effective Jan. 1, 2018
  • Apheresis – Effective Jan. 1, 2018
  • Breast Imaging for Screening and Diagnosing Cancer – Effective Jan. 1, 2018
  • Brineura™ (Cerliponase Alfa) – Effective Jan. 1, 2018
  • Clotting Factors and Coagulant Blood Products – Effective Jan. 1, 2018
  • Cochlear Implants – Effective Jan. 1, 2018
  • Cognitive Rehabilitation – Effective Jan. 1, 2018
  • Continuous Glucose Monitoring and Insulin Delivery for Managing Diabetes – Effective Jan. 1, 2018
  • Cosmetic and Reconstructive Procedures – Effective Jan. 1, 2018
  • Emergency Health Care Services and Urgent Care Center Services – Effective Jan. 1, 2018
  • Exondys 51™ (Eteplirsen) – Effective Jan. 1, 2018
  • Extracorporeal Shock Wave Therapy (ESWT) – Effective Jan. 1, 2018
  • Functional Endoscopic Sinus Surgery (FESS) – Effective Jan. 1, 2018
  • Genetic Testing For Hereditary Cancer – Effective Jan. 1, 2018
  • Habilitative Services for Essential Health Groups – Effective Jan. 1, 2018
  • Hearing Aids and Devices Including Wearable, Bone-Anchored and Semi-Implantable – Effective Jan. 1, 2018
  • Immune Globulin (IVIG and SCIG) – Effective Jan. 1, 2018
  • Infertility Diagnosis and Treatment – Effective Jan. 1, 2018
  • Maximum Dosage – Effective Jan. 1, 2018
  • Molecular Oncology Testing for Cancer Diagnosis, Prognosis, and Treatment Decisions – Effective Jan. 1, 2018
  • Ocrevus™ (Ocrelizumab) – Effective Jan. 1, 2018
  • Omnibus Codes – Effective Jan. 1, 2018
  • Preventive Care Services – Effective Jan. 1, 2018
  • Probuphine® (Buprenorphine) – Effective Jan. 1, 2018
  • Prolotherapy for Musculoskeletal Indications – Effective Jan. 1, 2018
  • Prosthetic Devices, Wigs, Specialized, Microprocessor or Myoelectric Limbs – Effective Jan. 1, 2018
  • Rehabilitation Services (Outpatient) – Effective Jan. 1, 2018
  • Sodium Hyaluronate – Effective Jan. 1, 2018
  • Spinal Ultrasonography – Effective Jan. 1, 2018
  • Spinraza™ (Nusinersen) – Effective Jan. 1, 2018
  • Stelara® (Ustekinumab) – Effective Jan. 1, 2018
  • Surgical and Ablative Procedures for Venous Insufficiency and Varicose Veins – Effective Feb. 1, 2018
  • Surgical Treatment for Spine Pain – Effective Jan. 1, 2018
  • Total Artificial Heart – Effective Jan. 1, 2018
  • Transcatheter Heart Valve Procedures – Effective Feb. 1, 2018
  • Transcranial Magnetic Stimulation – Effective Jan. 1, 2018

 

January 2018 Medical Policy Updates

UPDATED

  • Cardiovascular Disease Risk Tests – Effective Jan. 1, 2018
  • Deep Brain and Cortical Stimulation – Effective Feb. 1, 2018
  • Electrical Stimulation and Electromagnetic Therapy for Wounds – Effective Jan. 1, 2018
  • Fetal Aneuploidy Testing Using Cell-Free Fetal Nucleic Acids in Maternal Blood – Effective Jan. 1, 2018
  • Intensity-Modulated Radiation Therapy – Effective Jan. 1, 2018
  • Mechanical Stretching Devices – Effective Feb. 1, 2018
  • Surgical Treatment for Spine Pain – Effective Feb. 1, 2018
  • Temporomandibular Joint Disorders – Effective Feb. 1, 2018

 

REVISED

  • Bariatric Surgery – Effective Feb. 1, 2018
  • Electrical Stimulation for the Treatment of Pain and Muscle Rehabilitation – Effective Mar. 1, 2018
  • Hearing Aids and Devices Including Wearable, Bone-Anchored and Semi-Implantable – Effective Jan. 1, 2018
  • Implantable Beta-Emitting Microspheres for Treatment of Malignant Tumors – Effective Feb. 1, 2018
  • Infertility Diagnosis and Treatment – Effective Feb. 1, 2018
  • Surgical and Ablative Procedures for Venous Insufficiency and Varicose Veins – Effective Feb. 1, 2018
  • Transcatheter Heart Valve Procedures – Effective Feb. 1, 2018
  • Whole Exome and Whole Genome Sequencing – Effective Mar. 1, 2018

 

RETIRED

  • Standing Systems and Gait Trainers – Effective Jan. 1, 2018

 

Medical Benefit Drug Policy Updates

NEW

  • Alpha1-Proteinase Inhibitors – Effective Feb. 1, 2018

 

UPDATED

  • 17-Alpha-Hydroxyprogesterone Caproate (Makena™ and 17P) – Effective Jan. 1, 2018
  • Botulinum Toxins A and B – Effective Jan. 1, 2018

 

REVISED

  • Clotting Factors and Coagulant Blood Products – Effective Jan. 1, 2018
  • Enzyme Replacement Therapy – Effective Jan. 1, 2018
  • Immune Globulin (IVIG and SCIG) – Effective Jan. 1, 2018
  • Ophthalmologic Policy: Vascular Endothelial Growth Factor (VEGF) Inhibitors – Effective Jan. 1, 2018
  • Respiratory Interleukins (Cinqair®, Fasenra®, and Nucala®) – Effective Jan. 1, 2018
  • Simponi Aria® (Golimumab) Injection for Intravenous Infusion – Effective Jan. 1, 2018
  • Soliris® (Eculizumab) – Effective Jan. 1, 2018
  • Somatostatin Analogs – Effective Feb. 1, 2018

 

Coverage Determination Guideline (CDG) Updates

UPDATED

  • Speech Language Pathology Services – Effective Feb. 1, 2018

 

REVISED

  • Preventive Care Services – Effective Jan. 1, 2018

 

Click here to view the United Healthcare Medical Policy Updates »

 

Policy Alerts monitors Commercial and Medicare medical policies for changes. While Payers typically update medical policies annually, there are many reasons why a Payer might review or update a policy. When reviews occur out of cycle, they may go unnoticed. Policy Alerts keeps you informed of upcoming and unexpected coverage changes affecting your product. Quickly understanding the changes Payers make can help you adjust reimbursement strategies impacting your business.

Policy Alerts continuously monitors Commercial and Medicare Payer coverage information to keep you up-to-date on Payer decisions in real-time. Whenever changes occur, email notifications containing a summary of those changes are delivered to your inbox. Clients can access detailed coverage reports and medical policies on the interactive Dashboard portal. Save time and keep focused on the important Payer medical policy reviews and coverage decisions affecting your product!

Policy Alerts takes a client-focused hands-on approach and works hard to provide our customers with helpful insights and actionable analytics over raw data. We understand what our clients need and we are dedicated to making sure we provide timely, accurate and always up-to-date reports that can be used to implement and support a successful reimbursement strategy.

Health economic and reimbursement information provided by Policy Alerts is gathered from third-party sources and is subject to change without notice as a result of complex and frequently changing laws, regulations, rules and policies. This information is presented for illustrative purposes only and does not constitute reimbursement or legal advice.

Back To Top