12/31/2019

Updated: Prior Auth for CPT 10060 & 10061 (In-Office Visits)-UHC

A few weeks ago we received an enewsletter from United Healthcare saying we would need PRE-AUTH. for 10060 and 10061 if done at outpatient facilites. Does that include in office??? We have sent FIVE emails to our rep and get zero responses, as usual!!! Thank you. We need this info ASAP!!!!!!!!!!

Effective October 01, 2019 UHC Commercial is requiring prior auth for CPT 10060 and 10061 for outpatient hospital settings only. For reference, I’ve attached the news bulletin with this information (pg. 20).  We have not come across any denials. We will provide an update if any new information is obtained.

The authorization requirement for CPT codes 10060 & 10061 does not apply to the office. Minor procedures in the office or a participating ambulatory surgical center do not require authorization as long as the provider is in network.

See link below

Uhc Commercial Advance Notification Prior Authorization Requirements 10.01.2019