New codes added to radiology and cardiology prior authorization programs
To comply with the American Medical Association’s recent changes, on April 1, 2026, we’ll add additional advanced imaging and cardiology procedure codes to the outpatient radiology and cardiology prior authorization programs. This change applies to UnitedHealthcare commercial plans, UnitedHealthcare Community Plans, UnitedHealthcare Individual Exchange Plans, UnitedHealthcare Oxford Plans and Rocky Mountain Health Plan.
These code additions don’t apply to UnitedHealthcare® Medicare Advantage or Dual Special Needs Plan (D-SNP) plans.
The following charts outline the radiology and cardiology code additions for UnitedHealthcare commercial plans, UnitedHealthcare Community Plans, UnitedHealthcare Individual Exchange Plans, Oxford Plans and Rocky Mountain Health Plans:
Radiology code additions
| CPT® code | Procedure |
|---|---|
| 70472 | Computed tomographic (CT) cerebral perfusion analysis with concurrent CT or CT angiography of the same anatomy |
| 70473 | CT cerebral perfusion analysis without concurrent CT or CT angiography of the same anatomy |
| 0865T | Quantitative analysis of a brain magnetic resonance image (MRI) |
| 0866T | Quantitative analysis of a brain MRI |
| 0742T | Nuclear cardiology – Absolute quantification of myocardial blood flow |
Cardiology code additions*
| CPT code | Procedure |
|---|---|
| 0795T | Electrophysiology implant device – dual chamber leadless pacemaker |
| 0796T | Electrophysiology implant device – dual chamber leadless pacemaker |
| 0797T | Electrophysiology implant device – dual chamber leadless pacemaker |
| 0801T | Electrophysiology implant device – dual chamber leadless pacemaker |
| 0802T | Electrophysiology implant device – dual chamber leadless pacemaker |
| 0803T | Electrophysiology implant device – dual chamber leadless pacemaker |
| 33274 | Electrophysiology implant device – right ventricular leadless pacemaker |
| 0823T | Electrophysiology implant device – transcatheter insertion of permanent single-chamber leadless pacemaker |
| 0825T | Electrophysiology implant device – transcatheter insertion of permanent single-chamber leadless pacemaker |
*Oxford Health Plans will not require prior authorization for these cardiology CPT codes.
Services not requiring review
These requirements don’t apply to advanced imaging and cardiology services provided in an:
- Emergency room
- Urgent care center
- Observation unit
- Inpatient stay
How to submit and manage prior authorizations
- Sign in to the UnitedHealthcare Provider Portal with your One Healthcare ID
- If you don’t have a One Healthcare ID, register now
- From the left-hand tabs, select Prior Authorizations & Notifications
Resources
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