UnitedHealthcare Orthognathic Surgery prior authorization requirements (2026)

What UnitedHealthcare generally requires to approve Orthognathic Surgery (CPT 21010, 21050, 21060), for Commercial plans. Yes. UnitedHealthcare generally requires prior authorization for Orthognathic Surgery (CPT 21010, 21050, 21060).

General reference compiled from public sources, last verified 2026-05-06. This is not a coverage determination or medical advice. Always confirm current requirements with UnitedHealthcare before submitting.

Medical-necessity criteria UnitedHealthcare generally applies

Prior authorization required for maxillofacial functional impairment treatment

Commonly required documentation

  • Submit via UHCprovider.com portal

How to submit

  • Method: portal
  • Portal: Evicore
  • Typical turnaround: about 3 days

Source

Covers jaw repositioning and reconstruction procedures Last verified 2026-05-06.

Frequently asked questions

Does UnitedHealthcare require prior authorization for Orthognathic Surgery?

Yes. UnitedHealthcare generally requires prior authorization for Orthognathic Surgery (CPT 21010, 21050, 21060).

What does UnitedHealthcare require to approve Orthognathic Surgery?

Prior authorization required for maxillofacial functional impairment treatment Always confirm against the current UnitedHealthcare policy.

How long does a UnitedHealthcare prior authorization take?

UnitedHealthcare typically decides Orthognathic Surgery requests in about 3 days. Timeframes vary; check the payer portal.

Submitting Orthognathic 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.

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Other UnitedHealthcare prior authorization requirements

ACL ReconstructionAnterior Cervical Discectomy and FusionArthroplasty (Joint Replacement)Arthroscopic Hip Surgery for Impingement Syndrome Including Labral RepairArthroscopyBariatric SurgeryBariatric Surgery with Obesity DiagnosisBody LengtheningBone Growth Stimulator - Electronic Stimulation or UltrasoundBone Marrow/Stem Cell ProceduresBreast Reconstruction (Non-Mastectomy)Cancer Supportive Care - Antiemetic Drugs

Related guides

Why was my prior authorization denied? Top reasons and how to fix eachHow to write a prior authorization appeal that cites policy