United Healthcare (UHC) Medical Policy Updates – October 2023

Click here to view the United Healthcare (UHC) Medical Policy Updates »

• Ablative Treatment for Spinal Pain
• Abnormal Uterine Bleeding and Uterine Fibroids
• Adakveo ®(Crizanlizumab-Tmca)
• Airway Clearance Devices
• Ambulance Services
• Apheresis
• Articular Cartilage Defect Repairs
• Assisted Administration of Clotting Factors, Coagulant Blood Products & Other Hemostatics (for Oxford Only)
• Athletic Pubalgia Surgery
• Autologous Cellular Therapy
• Balloon Sinus Ostial Dilation
• Bariatric Surgery
• Beds and Mattresses
• Botulinum Toxins A and
• Breast Imaging for Screening and Diagnosing Cancer
• Breast Reconstruction
• Breast Reduction Surgery
• Bronchial Thermoplasty
• Brow Ptosis and Eyelid Repair
• Cardiac Event Monitoring
• Cardiovascular Disease Risk Tests
• Carrier Testing for Genetic Diseases
• Catheter Ablation for Atrial Fibrillation
• Cell-Free Fetal DNA Testing
• Chelation Therapy for Non-Overload Conditions
• Chemotherapy Observation or Inpatient Hospitalization
• Chromosome Microarray Testing
• Clinical Trials
• Clotting Factors and Coagulant Blood Products
• Cochlear Implants
• Cognitive Rehabilitation
• Collagen Crosslinks and Biochemical Markers of Bone Turnover
• Computed Tomographic Colonography
• Computerized Dynamic Posturography
• Continuous Glucose Monitoring and Insulin Delivery for Managing Diabetes
• Core Decompression for Avascular Necrosis
• Corneal Hysteresis and Intraocular Pressure Measurement
• Cosmetic and Reconstructive Procedures
• Cytological Examination of Breast Fluids for Cancer Screening
• Deep Brain and Cortical Stimulation
• Denosumab (Prolia ®& Xgeva®)
• Diagnostic Dynamic Spinal Visualization and Vertebral Motion Analysis
• Diagnostic Spinal Ultrasonography
• Discogenic Pain Treatment
• Durable Medical Equipment, Orthotics, Ostomy Supplies, Medical Supplies and Repairs/Replacements
• Elective Inpatient Services
• Electric Tumor Treatment Field Therapy
• Electrical and Ultrasound Bone Growth Stimulators
• Electrical Bioimpedence for Cardiac Output Measurement
• Electrical Stimulation for the Treatment of Pain and Muscle Rehabilitation
• Eloctate  [Antihemophilic Factor (Recombinant), FC Fusion Protein] for Connecticut Lines of Business (for Oxford Only)
• Embolization of the Ovarian and Iliac Veins for Pelvic Congestion Syndrome
• Environmental Allergen Immunotherapy
• Enzyme Replacement Therapy
• Epidural Steroid Injections for Spinal Pain
• Evenity™ (Romosozumab-Aqqg)
• Extracorporeal Shock Wave Therapy (ESWT)
• Facet Joint Injections for Spinal Pain
• Fecal Calprotectin Testing
• Functional Endoscopic Sinus Surgery
• Gastrointestinal Motility Disorders, Diagnosis and Treatment
• Gastrointestinal Pathogen Nucleic Acid Detection Panel Testing for Infectious Diarrhea
• Genetic Testing for Cardiac Disease
• Genetic Testing for Hereditary Cancer
• Genetic Testing for Neuromuscular Disorders
• Genitourinary Pathogen Nucleic Acid Detection Panel Testing
• Glaucoma Surgical Treatments
• Gynecomastia Surgery
• Habilitative Services and Outpatient Rehabilitation Therapy
• Hepatitis Screening
• Home Hemodialysis
• Home Traction Therapy
• Hospital Services: Observation and Inpatient
• Hyperbaric Oxygen Therapy and Topical Oxygen Therapy
• Hysterectomy
• Immune Globulin (IVIG and SCIG)
• Implantable Beta-Emitting Microspheres for Treatment of Malignant Tumors
• Implanted Electrical Stimulator for Spinal Cord
• Implanted Spinal Drug Delivery Systems
• Infertility Diagnosis and Treatment
• Intensity-Modulated Radiation Therapy
• Intraoperative Hyperthermic Intraperitoneal Chemotherapy (HIPEC)
• Intrauterine Fetal Surgery
• Laser Interstitial Thermal Therapy
• Left Atrial Appendage Closure (Occlusion)
• Light and Laser Therapy
• Liposuction for Lipedema
• Lithotripsy for Salivary Stones
• Lower Extremity Endovascular Procedures
• Macular Degeneration Treatment Procedures
• Magnetic Resonance Imaging (MRI) and Computed Tomography (CT) Scan  –Site of Service
• Manipulation Under Anesthesia
• Manipulative Therapy
• Mechanical Stretching Devices
• Medical Records Requirements for Pre-Service
• Minimally Invasive Procedures for Gastroesophageal  Reflux Disease (GERD) and Achalasia
• Molecular Oncology Testing for Cancer Diagnosis, Prognosis, and Treatment Decisions
• Motorized Spinal Traction
• Negative Pressure Wound Therapy
• Nerve Graft to Restore Erectile Function During Radical Prostatectomy
• Neurophysiologic Testing
• Neuropsychological Testing Under the Medical Benefit
• Noncontact Warming Therapy, Ultrasound Therapy and Fluorescence Imaging for Wounds
• Obstetrical Ultrasound
• Obstructive Sleep Apnea Treatment
• Occipital Neuralgia and Headache Treatment
• Office Based Procedures – Site of Service
• Omnibus Codes
• Oncology Medication Clinical Coverage
• Orthognathic (Jaw) Surgery
• Panniculectomy and Body Contouring Procedures
• Patient Lifts
• Pectus Deformity Repair
• Pediatric Gait Trainers and Standing Systems
• Percutaneous Neuroablation for Severe Cancer Pain and Trigeminal Neuralgia
• Percutaneous Patent Foramen Ovale (PFO) Closure
• Percutaneous Vertebroplasty and Kyphoplasty
• Pharmacogenetic Testing
• Plagiocephaly and Craniosynstosis Treatment
• Pneumatic Compression Devices
• Preimplantation Genetic Testing
• Preventive Care Services
• Private Duty Nursing Services (PDN)
• Prolotherapy and Platelet Rich Plasma Therapies
• Prostate Surgeries and Interventions
• Proton Beam Radiation Therapy
• Provider Administered Drugs – Site of Care
• Repository Corticotropin Injection
• Respiratory Interleukins (Cinqair®, Fasenra®, and Nucala )®
• Review at Launch for New to Market Medications
• Rhinoplasty and Other Nasal Surgeries
• Sacroiliac Joint Interventions
• Screening Colonoscopy Procedures – Site of Service
• Self-Administered Medications
• Sensory Integration Therapy and Auditory Integration Training
• Skin and Soft Tissue Substitutes
• Skyrizi  (Risankizumab-Rzaa)
• Soliris (eculizumab), Ultomiris (ravulizumab-cwvz)
• Speech Generating Devices
• Spinal Fusion and Bone Healing Enhancement Products
• Stereotactic Body Radiation Therapy and Stereotactic Radiosurgery
• Surgery of the Ankle
• Surgery of the Elbow
• Surgery of the Foot
• Surgery of the Hand or Wrist
• Surgery of the Hip
• Surgery of the Knee
• Surgery of the Shoulder
• Surgical and Ablative Procedures for Venous Insufficiency and Varicose Veins
• Surgical Treatment of Lymphedema
• Sympathetic Blockade
• Temporomandibular Joint Disorders
• Tezspire  (Tezepelumab-Ekko)
• Thermography
• Total Artificial Disc Replacement for the Spine
• Total Artificial Heart
• Transcatheter Heart Valve Procedures
• Transcranial Magnetic Stimulation
• Transpupillary Thermotherapy
• Umbilical Cord Blood Harvesting and Storage for Future Use
• Unicondylar Spacer Devices for Treatment of Pain or Disability
• Vagus Nerve Stimulation
• Vascular Endothelial Growth Factor (VEGF) Inhibitors
• Vertebral Body Tethering for Scoliosis
• Video Electroencephalographic (vEEG) Monitoring and Recording
• Virtual Upper Gastrointestinal Endoscopy
• Visual Information Processing Evaluation and Orthoptic and Vision Therapy
• Vitamin D Testing
• Vyepti™ (Eptinezumab)
• Vyvgart  (Efgartigimod Alfa-Fcab)
• Walkers
• Whole Exome and Whole Genome Sequencing
• Xolair ®(Omalizumab)

Click here to view the United Healthcare (UHC) Medical Policy Updates »

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