UnitedHealthcare has developed Medical Policies, Medical Benefit Drug Policies, Coverage Determination Guidelines, and Utilization Review Guidelines to assist us in administering health benefits. Effective Date: 12.01.2020 – This policy addresses the use of Luxturna™ (voretigene neparvovec-rzyl) for the treatment of inherited retinal dystrophies (IRD) caused by mutations in the retinal pigment epithelium-specific protein 65kDa (RPE65) gene. Email. Members must have Medicaid to enroll. Effective Date: 02.01.2021 – This policy addresses Simponi Aria® (golimumab) injection for intravenous infusion for the treatment of ankylosing spondylitis, psoriatic arthritis, rheumatoid arthritis, and polyarticular juvenile idiopathic arthritis. There were 558 Medicare ACOs serving more than 12.3 million beneficiaries, with hundreds more commercial and Medicaid ACOs, as of January 2020, according to … Reimbursement associated with this Plan Summary is subject to the plan limitations and provider’s scope of practice, up to … UnitedHealthcare® Commercial & Medicare Programs Chiropractic Plan Summary Revised: 11/01/16 This OptumHealth Care Solutions, Inc. (Optum) Plan Summary is applicable to UnitedHealthcare Commercial and Medicare programs noted below. Effective Date: 10.01.2020 – This policy addresses implanted electrical stimulator for spinal cord. Effective Date: 08.01.2020 – This policy addresses breast ductal lavage, breast ductal fluid aspiration and cytology, and fiberoptic ductoscopy with or without ductal lavage. Applicable Procedure Codes: J1437, J1439, Q0138. Applicable Procedure Codes: J7170, J7175, J7177, J7178, J7179, J7180, J7181, J7182, J7183, J7185, J7186, J7187, J7188, J7189, J7190, J7192, J7193, J7194, J7195, J7198, J7199, J7200, J7201, J7202, J7203, J7204, J7205, J7207, J7208, J7209, J7210, J7211, J7212. Applicable Procedure Codes: C9399, J3490, J3590. Applicable Procedures Codes: C9399, J3490, J3590. Effective Date: 07.01.2020 – This policy addresses the use of Givlaari® (givosiran) for the treatment of acute hepatic porphyrias. Applicable Procedure Codes: 55899, 64999. Please confirm that a provider is in your plan's network before each visit. Applicable Procedure Code: J0896. UnitedHealth Group Incorporated is an American for-profit managed health care company based in Minnetonka, Minnesota.It offers health care products and insurance services. Administrative Guide for Commercial, Medicare Advantage and DSNP; Welcome to UnitedHealthcare 2021 Administrative Guide; Quick reference guide 2021 Administrative Guide; Introduction. Applicable Procedure Codes: 0278T, 63650, 63655, 63685, 64999, E0744, E0745, E0762, E0764, E0770, E1399, L8679, L8680, L8682, L8685, L8686, L8687, L8688, S8130, S8131. Watch Plus First Month Free Consumer Cellular TV Commercial … Effective Date: 11.01.2020 – This policy addresses the use of buprenorphine (Probuphine® and Sublocade™) for the treatment of opioid dependence/opioid use disorder. Effective Date: 09.01.2020 – This policy addresses the use of Xolair® (omalizumab) for subcutaneous use for the treatment of moderate to severe persistent asthma and chronic urticaria. Effective Date: 01.01.2021 – This policy addresses the use of vascular endothelial growth factor (VEGF) inhibitors. Effective Date: 01.01.2021 – This policy addresses preventive care services. Applicable Procedure Code: 22899. In the event of an inconsistency or conflict between the information provided in the Medical Policy Update Bulletin and the posted policy, the provisions of the posted policy will prevail. Effective Date: 10.01.2020 – This policy addresses the use of Adakveo® (crizanlizumab-tmca) to reduce the frequency of vasoocclusive crises in patients with sickle cell disease. Healthlink. Commercial Insurance Company. Applicable Procedure Codes: 0071T, 0072T, 0404T, 37243, 58578, 58674, 58999, J7296, J7297, J7298, J7301, J7306, S4981. Applicable Procedure Code: J0606. Effective Date: 01.01.2021 – This policy addresses gender dysphoria treatment, including surgical treatment and certain ancillary procedures. Our Medical Policies and Medical Benefit Drug Policies express our determination of whether a health service (e.g., test, drug, device or procedure) is proven to be effective based on the published clinical evidence. This reference guide has step-by-step instructions on how to find the Medicare ID. Are Your Patients Reluctant to Ask Questions? Effective Date: 01.01.2021 – This policy addresses the use of cranial orthotic devices for treating infants with plagiocephaly and craniosynostosis. … Effective Date: 04.01.2020 – This policy addresses electroencephalographic (EEG) monitoring and video recording. Applicable Procedure Codes: 22899, 27299, 64625, 64633, 64634, 64635, 64636, 64999. Effective Date: 01.01.2021 – This policy addresses computer-assisted surgical navigation for musculoskeletal procedures and the use of intra-operative kinetic balance sensor for implant stability during knee replacement arthroplasty. Applicable Procedure Code: 94799. Effective Date: 11.01.2020 – This policy addresses shoulder replacement surgery (arthroplasty and hemiarthroplasty). Login here! Applicable Procedure Codes: 37220, 37221, 37222, 37223, 37224, 37225, 37226, 37227, 37228, 37229, 37230, 37231, 37232, 37233, 37234, 37235, 75710, 75716. Effective Date: 09.01.2020 – This policy addresses intraoperative hyperthermic intraperitoneal chemotherapy (HIPEC). Effective Date: 05.01.2020 – This policy addresses manipulation under anesthesia (MUA). Effective Date: 02.01.2021 – This policy addresses intra-articular injections of sodium hyaluronate. UnitedHealthcare due to programming or other constraints; however, UnitedHealthcare strives to minimize these variations. Arkansas, Colorado and Washington providers and members may review the MCG™ Care Guidelines at:  uhcarkansas.access.mcg.com/index (Arkansas) or uhccolorado.access.mcg.com/index (Colorado) or uhcwashington.access.mcg.com/index (Washington). Applicable Procedure Code: 19300. Applicable Procedure Codes: 97610, A6000, E0231, E0232. Learn about our prescription benefits and health networks now. Effective Date: 01.01.2021 – This policy addresses lysis intranasal synechia, repair of nasal vestibular stenosis or alar collapse, rhinoplasty, rhinophyma, and septal dermatoplasty. Effective Date: 01.01.2021 – This policy addresses genetic testing for cardiac disease. Effective Date: 05.01.2020 – This policy addresses the use of Entyvio® (vedolizumab) for the treatment of Crohn's disease, ulcerative colitis, and immune checkpoint inhibitor-related toxicities. For California members, note that the materials provided to you are guidelines used by this plan to authorize, modify, or deny care for persons with similar illnesses or conditions. For questions, please contact your local Network Management representative or call the Provider Services number on the back of the member’s ID card. Effective Date: 12.01.2020 – This policy addresses the use of Evenity® (romosozumab- aqqg) for the treatment of osteoporosis in postmenopausal patients at high risk for fracture. Effective Date: 12.01.2020 – This policy addresses skin and soft tissue substitutes. Applicable Procedure Codes: 20605, 20606, 20610, 20611, J3490, J7318, J7320, J7321, J7322, J7323, J7324, J7325, J7326, J7327, J7328, J7329, J7331, J7332, J7333. The appearance of a health service (e.g., test, drug, device or procedure) in the Medical Policy Update Bulletin does not imply that UnitedHealthcare provides coverage for the health service. Applicable Procedure Codes: 21175, D5924, L0112, L0113, S1040. Rebundling Policy, Professional - Reimbursement Policy - UnitedHealthcare Commercial Plans. Register or login to your UnitedHealthcare health insurance member account. Applicable Procedure Codes: J0517, J2182, J2786. To view the UnitedHealthcare Commercial Plan Review at Launch Medication List, go to UHCprovider.com > Policies and Protocols >

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