UnitedHealthcare Cardiovascular Interventions prior authorization requirements (2026)
What UnitedHealthcare generally requires to approve Cardiovascular Interventions (CPT 33285, 37220, 37221, 37224, 37225, 37226, 37227, 37228, 37229, 37230, 37231, 93580, 93653, 93656, E0616), for Commercial plans. Yes. UnitedHealthcare generally requires prior authorization for Cardiovascular Interventions (CPT 33285, 37220, 37221, 37224, 37225, 37226, 37227, 37228, 37229, 37230, 37231, 93580, 93653, 93656, E0616).
Medical-necessity criteria UnitedHealthcare generally applies
Patient requires cardiovascular intervention. Prior authorization NOT required for specific atherosclerosis and peripheral vascular disease diagnosis codes (E08.52, E09.52, E10.52, E11.52, E13.52, I70.xxx series, I72.x, I73.xx, I74.x, I75.xxx, I77.xx). Code 93580 requires prior authorization for members ages 18 and older.
Diagnoses that commonly support medical necessity
ICD-10-CM diagnoses frequently associated with medical necessity for Cardiovascular Interventions. Confirm the covered diagnosis list against the current UnitedHealthcare policy.
Commonly required documentation
- Clinical documentation including cardiovascular disease indication, imaging studies, treatment rationale
How to submit
- Method: portal
- Portal: UnitedHealthcare
- Typical turnaround: about 3 days
Source
Prior authorization not required for specific diagnosis codes listed. Code 93580 requires prior authorization for members 18 and older only. Last verified 2026-05-06.
Frequently asked questions
Does UnitedHealthcare require prior authorization for Cardiovascular Interventions?
Yes. UnitedHealthcare generally requires prior authorization for Cardiovascular Interventions (CPT 33285, 37220, 37221, 37224, 37225, 37226, 37227, 37228, 37229, 37230, 37231, 93580, 93653, 93656, E0616).
What does UnitedHealthcare require to approve Cardiovascular Interventions?
Patient requires cardiovascular intervention. Prior authorization NOT required for specific atherosclerosis and peripheral vascular disease diagnosis codes (E08.52, E09.52, E10.52, E11.52, E13.52, I70.xxx series, I72.x, I73.xx, I74.x, I75.xxx, I77.xx). Code 93580 requires prior authorization for members ages 18 and older. Always confirm against the current UnitedHealthcare policy.
How long does a UnitedHealthcare prior authorization take?
UnitedHealthcare typically decides Cardiovascular Interventions requests in about 3 days. Timeframes vary; check the payer portal.
Submitting Cardiovascular Interventions 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.