Oxford Health Plans Arthroscopic Hip Surgery for Impingement Syndrome Including Labral Repair prior authorization requirements (2026)
What Oxford Health Plans generally requires to approve Arthroscopic Hip Surgery for Impingement Syndrome Including Labral Repair (CPT 29914, 29915, 29916, 29860, 29861, 29862, 29863), for commercial plans. Yes. Oxford Health Plans generally requires prior authorization for Arthroscopic Hip Surgery for Impingement Syndrome Including Labral Repair (CPT 29914, 29915, 29916, 29860, 29861, 29862, 29863).
Medical-necessity criteria Oxford Health Plans generally applies
Prior authorization required (29860-29863, 29914-29916). Submit via the UnitedHealthcare Provider Portal; medical necessity is adjudicated against InterQual CP: Hip Arthroscopy (proprietary — confirm specifics). Documented exclusion: FAI surgery is not medically necessary with advanced osteoarthritis (Tonnis Grade 2-3) and/or severe cartilage damage (Outerbridge III-IV).
How to submit
- Method: UHC Provider Portal
- Portal: UnitedHealthcare Provider Portal
Sources & verification
- BindingSource — UHC Commercial/Exchange Medical Policy — Surgery of the Hip (2026T0503JJ) · effective 2026-03-01.View
Binding = the payer's own policy. Proxy = a public, evidence-based clinical guideline the payer mirrors. Portal-only = the binding criteria are confirmed in the administrator's portal. Always confirm against the payer for the member's specific plan. Last verified 2026-06-26.
Frequently asked questions
Does Oxford Health Plans require prior authorization for Arthroscopic Hip Surgery for Impingement Syndrome Including Labral Repair?
Yes. Oxford Health Plans generally requires prior authorization for Arthroscopic Hip Surgery for Impingement Syndrome Including Labral Repair (CPT 29914, 29915, 29916, 29860, 29861, 29862, 29863).
What does Oxford Health Plans require to approve Arthroscopic Hip Surgery for Impingement Syndrome Including Labral Repair?
Prior authorization required (29860-29863, 29914-29916). Submit via the UnitedHealthcare Provider Portal; medical necessity is adjudicated against InterQual CP: Hip Arthroscopy (proprietary — confirm specifics). Documented exclusion: FAI surgery is not medically necessary with advanced osteoarthritis (Tonnis Grade 2-3) and/or severe cartilage damage (Outerbridge III-IV). Always confirm against the current Oxford Health Plans policy.
How long does a Oxford Health Plans prior authorization take?
Turnaround varies by plan and submission method. Check the Oxford Health Plans portal for current timeframes.
Submitting Arthroscopic Hip Surgery for Impingement Syndrome Including Labral Repair to Oxford Health Plans?
Praxigen checks your clinical note against these criteria before you submit and drafts a policy-cited appeal if it is denied. You review and submit; nothing is sent automatically.