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UnitedHealthcareCommercial · Prior Auth · Network News · Radiology, Cardiology, NeurologyMedium impact

New radiology and cardiology prior authorization codes

Effective date
Apr 1, 2026
Identified
Jun 13, 2026

Summary

Starting April 1, 2026, UnitedHealthcare will require prior authorization for 5 new radiology codes (including CT cerebral perfusion and brain MRI analysis) and 8 new cardiology codes (primarily dual chamber and leadless pacemaker procedures) across most commercial and Medicaid plans, but not Medicare Advantage plans.

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What to do

Action · 4 steps
01Before April 1, 2026: Billing team must update prior authorization system to require pre-approval for the 13 new radiology and cardiology codes listed.
02Update encounter forms and EMR templates to alert providers when these procedures require prior auth.
03Note that Oxford Health Plans are exempt from cardiology code prior auth requirements.
04Emergency room, urgent care, observation unit, and inpatient services are exempt from these requirements.

Codes mentioned

704727047333274

Original notice

New radiology and cardiology prior authorization codes
uhcprovider.com · Always check the source before changing claims.
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Related changes

See all UnitedHealthcare changes →
New radiology and cardiology prior authorization codesHighEffective Apr 1, 2026 · Prior authorization updatesNew codes added to outpatient radiology prior authorization programMediumEffective Sep 1, 2026 · Prior authorizationBrowse every UnitedHealthcare change in the policy list

Related policy hubs

UnitedHealthcare policiesRadiologyCardiologyNeurologyCode 70472Code 70473Code 33274

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