UnitedHealthcare Bariatric Surgery prior authorization requirements (2026)
What UnitedHealthcare generally requires to approve Bariatric Surgery (CPT 43659, 43772, 43774, 43886, 43887, 43888), for Commercial plans. Yes. UnitedHealthcare generally requires prior authorization for Bariatric Surgery (CPT 43659, 43772, 43774, 43886, 43887, 43888).
Medical-necessity criteria UnitedHealthcare generally applies
Patient meets bariatric surgery criteria. Center of Excellence requirement for coverage. Some benefit plans may not cover obesity-related services.
Diagnoses that commonly support medical necessity
ICD-10-CM diagnoses frequently associated with medical necessity for Bariatric Surgery. Confirm the covered diagnosis list against the current UnitedHealthcare policy.
Commonly required documentation
- Clinical documentation including BMI, comorbidities, weight loss attempts, and medical necessity
How to submit
- Method: portal
- Portal: UnitedHealthcare
- Typical turnaround: about 3 days
Source
Center of Excellence requirement applies. In certain situations, bariatric surgery and other obesity-related services are not covered by some benefit plans. Last verified 2026-05-06.
Frequently asked questions
Does UnitedHealthcare require prior authorization for Bariatric Surgery?
Yes. UnitedHealthcare generally requires prior authorization for Bariatric Surgery (CPT 43659, 43772, 43774, 43886, 43887, 43888).
What does UnitedHealthcare require to approve Bariatric Surgery?
Patient meets bariatric surgery criteria. Center of Excellence requirement for coverage. Some benefit plans may not cover obesity-related services. Always confirm against the current UnitedHealthcare policy.
How long does a UnitedHealthcare prior authorization take?
UnitedHealthcare typically decides Bariatric Surgery requests in about 3 days. Timeframes vary; check the payer portal.
Submitting Bariatric Surgery to UnitedHealthcare?
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.