Medicare AdvantagePrior AuthHigh impact
Heart catheter authorization update
UPMC Health Plan·Cardiology, Cardiothoracic Surgery·Prior Authorization
Effective date
Sep 20, 2022
We identified it
Aug 7, 2026
Summary
Effective September 20, 2022, UPMC removed prior authorization requirements for two heart catheter procedures: right heart catheter (CPT 93456) and left heart catheter (CPT 93452). Billing teams must immediately update their authorization workflows to stop requesting prior auth for these codes to avoid processing delays.
Action Required
By September 20, 2022: Billing team and authorization staff must update UPMC authorization submission rules in the billing system to remove prior authorization requirements for CPT 93456 (right heart catheter) and CPT 93452 (left heart catheter). Remove these codes from any authorization request workflows, templates, and provider communication checklists. Inform cardiology and interventional radiology providers that these procedures no longer require pre-authorization. Failure to update the system may result in unnecessary authorization delays and claim processing inefficiencies. Contact UPMC Utilization Management at 1-800-425-7800 with questions.