UnitedHealthcare Hip Osteotomy prior authorization requirements (2026)
What UnitedHealthcare generally requires to approve Hip Osteotomy (CPT 27146, S2115), for PPO plans. Based on the cited policy, UnitedHealthcare does not generally require prior authorization for Hip Osteotomy (CPT 27146, S2115). Confirm with UnitedHealthcare, as this can vary by plan.
Medical-necessity criteria UnitedHealthcare generally applies
Not on UnitedHealthcare's standard 2026 commercial Prior Authorization / Advance Notification list - CPT 27146 (and HCPCS S2115) are absent, so most commercial plans do not require PA for pelvic/periacetabular osteotomy under the standard list. There is NO standalone UHC medical policy governing 27146; the adjacent "Surgery of the Hip" policy (2026T0503JJ, eff 3/1/2026) does not include 27146/S2115 in its applicable codes and delegates hip medical necessity to InterQual CP: Procedures [NEEDS VERIFICATION]. Because PA applicability is plan-, state-, and site-of-service-specific, verify per-member via the UHC Provider Portal before scheduling.
Related procedure codes
Codes often billed alongside Hip Osteotomy: 27146, S2115. Verify the correct codes for your documentation.
Commonly required documentation
- If a specific plan flags PA: documentation per InterQual hip-surgery criteria (imaging, joint status, prior treatment). Verify per-member via the UHC Provider Portal.
How to submit
- Method: portal
- Portal: UnitedHealthcare Provider Portal
Sources & verification
- BindingSource — Commercial Advance Notification / Prior Authorization Requirements (27146/S2115 not listed) (PCA-1-24-01315) · effective 2026-01-01.View
- ProxySource — Surgery of the Hip - adjacent Commercial policy (does not cover 27146; InterQual-delegated) (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 2026-06-21.
Frequently asked questions
Does UnitedHealthcare require prior authorization for Hip Osteotomy?
Based on the cited policy, UnitedHealthcare does not generally require prior authorization for Hip Osteotomy (CPT 27146, S2115). Confirm with UnitedHealthcare, as this can vary by plan.
What does UnitedHealthcare require to approve Hip Osteotomy?
Not on UnitedHealthcare's standard 2026 commercial Prior Authorization / Advance Notification list - CPT 27146 (and HCPCS S2115) are absent, so most commercial plans do not require PA for pelvic/periacetabular osteotomy under the standard list. There is NO standalone UHC medical policy governing 27146; the adjacent "Surgery of the Hip" policy (2026T0503JJ, eff 3/1/2026) does not include 27146/S211… Always confirm against the current UnitedHealthcare policy.
How long does a UnitedHealthcare prior authorization take?
Turnaround varies by plan and submission method. Check the UnitedHealthcare portal for current timeframes.
Submitting Hip Osteotomy 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.