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UnitedHealthcareMedicare Advantage · Billing Codes · Medical Policy · Radiology, Nuclear Medicine, NeurologyMedium impact

Radiologic Diagnostic Procedures

Effective date
Dec 1, 2026
Identified
Nov 7, 2026

Summary

UnitedHealthcare's November 2026 Medicare Advantage bulletin revises the Radiologic Diagnostic Procedures policy effective 2026-12-01: amyloid brain PET coverage language in dementia and neurodegenerative disease was removed, CPT 78811 and 78814 were removed from the Positron Emission Tomography (Amyloid Brain) section, and Z59.7 was removed from the non-covered diagnosis codes. The bulletin also annotates a list of other nuclear medicine CPT codes as deleted (78012 through 78999 series codes marked 'deleted Dec. 31, 2025', and 78499 marked 'deleted Sep. 30, 2026') and removes a related-policy link to the GI services policy. Billing teams should update code tables and claim-entry edits so these codes are no longer used for these members.

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What to do

Action · 6 steps
01By 2026-12-01: Billing team should remove CPT 78811 and 78814 (amyloid brain PET) from active charge-entry lists and fee schedules for Medicare Advantage members, and stop using Z59.7 on claims for these members.
02Also, billing team should update charge master and code lookup tables to show the listed nuclear medicine codes as deleted (78012–78999 series deleted Dec.
0331, 2025; 78499 deleted Sep.
0430, 2026), and check that any claims or templates still using them are corrected.
05Providers and front desk staff should be told that amyloid brain PET is no longer addressed in this policy for dementia and neurodegenerative disease, so they can review documentation before ordering.
06Watch for the payer's next bulletin for any further policy updates.

Codes mentioned

7881178814Z59.7780127801378014780157801678018780707807578099781997822678227782997839978579785807858278597785987859978699787997880078801788027880478831788327899978499

Original notice

Radiologic Diagnostic Procedures
uhcprovider.com · Always check the source before changing claims.
View original ↗

Related changes

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Outpatient Radiology Procedures for EviCore Arrangement (for Oxford Only)HighEffective Nov 1, 2026 · Medical PolicyTier 2 Molecular Pathology ProceduresMediumEffective Nov 1, 2026 · Medical PolicyMolecular Pathology/Genetic Testing Reported with Unlisted CodesMediumEffective Nov 1, 2026 · Medical PolicyClinical Diagnostic Laboratory ServicesHighEffective Nov 1, 2026 · Medical PolicyBrowse every UnitedHealthcare change in the policy list

Related policy hubs

UnitedHealthcare policiesRadiologyNuclear MedicineNeurologyCode 78811Code 78814Code Z59.7Code 78012Code 78013Code 78014Code 78015Code 78016Code 78018Code 78070Code 78075Code 78099Code 78199Code 78226Code 78227Code 78299Code 78399Code 78579Code 78580Code 78582Code 78597Code 78598Code 78599Code 78699Code 78799Code 78800Code 78801Code 78802Code 78804Code 78831Code 78832Code 78999Code 78499

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