CommercialPrior AuthMedium impact
New genetic and molecular codes announced for prior authorization
UnitedHealthcare·Oncology, Pathology·Network News
Effective date
Apr 1, 2026
We identified it
Jun 13, 2026
Summary
Beginning April 1, 2026, UnitedHealthcare will require prior authorization for new genetic and molecular testing procedure code 0605U. This affects commercial and Individual Exchange plans, and claims will be denied without prior authorization.
Action Required
By April 1, 2026: Billing team must update system to require prior authorization for code 0605U before submitting claims for genetic and molecular testing. Use UnitedHealthcare Provider Portal to submit prior auth requests. Failure to obtain prior authorization will result in claim denials and prohibition on balance billing members.