UnitedHealthcare MRI Lower Extremity Joint without contrast prior authorization requirements (2026)
What UnitedHealthcare generally requires to approve MRI Lower Extremity Joint without contrast (CPT 73721), for Commercial plans. Yes. UnitedHealthcare generally requires prior authorization for MRI Lower Extremity Joint without contrast (CPT 73721).
Medical-necessity criteria UnitedHealthcare generally applies
Knee MRI without contrast is appropriate (per ACR Appropriateness Criteria for Chronic Knee Pain) when initial knee radiographs are normal or show an effusion; show osteochondritis dissecans, loose bodies, or a history of cartilage or meniscal repair; or when internal derangement (meniscal or ligamentous injury) is clinically suspected. Radiographs are the appropriate initial imaging for chronic knee pain and should be obtained first.
Situations to verify before submitting
UnitedHealthcare may not cover MRI Lower Extremity Joint without contrast in these situations. Verify against the current policy rather than assuming a denial:
- {"text":"Chronic knee pain imaged with MRI before obtaining initial knee radiographs (radiographs are the appropriate first study per ACR criteria)","source":"ACR Appropriateness Criteria: Chronic Knee Pain"}
Source
Advanced imaging PA for UnitedHealthcare is managed by eviCore. Criteria summarized from ACR Appropriateness Criteria Chronic Knee Pain. Source: jacr.org; eviCore radiology program. Last verified 2026-06-12.
Frequently asked questions
Does UnitedHealthcare require prior authorization for MRI Lower Extremity Joint without contrast?
Yes. UnitedHealthcare generally requires prior authorization for MRI Lower Extremity Joint without contrast (CPT 73721).
What does UnitedHealthcare require to approve MRI Lower Extremity Joint without contrast?
Knee MRI without contrast is appropriate (per ACR Appropriateness Criteria for Chronic Knee Pain) when initial knee radiographs are normal or show an effusion; show osteochondritis dissecans, loose bodies, or a history of cartilage or meniscal repair; or when internal derangement (meniscal or ligamentous injury) is clinically suspected. Radiographs are the appropriate initial imaging for chronic k… 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 MRI Lower Extremity Joint without contrast 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.