United Healthcare Medical Policy Pet Scan

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Positron Emission Tomography (PET) Scan

https://www.uhcprovider.com/content/dam/provider/docs/public/policies/medadv-guidelines/p/positron-emission-tomography-pet-scan.pdf

Myocardial imaging, positron emission tomography (PET), perfusion; multiple studies at rest and/or stress : 78608 . Brain imaging, positron emission tomography (PET); metabolic evaluation : 78811 . Positron emission tomography (PET) imaging; limited area (e.g., …

Positron Emission Tomography (PET)/ Combined …

https://www.uhcprovider.com/content/dam/provider/docs/public/policies/medadv-coverage-sum/positron-emission-tomography-pet-combined-pet-ct-computed-tomography.pdf

PET (FDG) and/or combined PET -CT scans are covered when determined to be medically necessary and specific criteria are met. Effective January 1, 2022, the Centers for …

UnitedHealthcare Commercial Medical & Drug Policies …

https://www.uhcprovider.com/en/policies-protocols/commercial-policies/commercial-medical-drug-policies.html

Effective Date: 12.01.2022 – This policy addresses breast imaging, including digital mammography, magnetic resonance imaging (MRI), ultrasound, automated breast …

Radiology Prior Authorization and Notification

https://www.uhcprovider.com/en/prior-auth-advance-notification/radiology-prior-authorization.html

Notification and prior authorization may be required for these advanced outpatient imaging procedures: CT scans*. MRIs*. MRAs*. PET scans. Nuclear medicine studies, including …

Radiologic Diagnostic Procedures - UHCprovider.com

https://www.uhcprovider.com/content/dam/provider/docs/public/policies/medadv-coverage-sum/radiologic-diagnostic-procedures.pdf

with these policies is required where applicable; see the list of available LCDs/LCAs for CCT and CCTA in the Supporting Information section of the policy o For states/territories …

Clinical Guidelines | UHCprovider.com

https://www.uhcprovider.com/en/policies-protocols/clinical-guidelines.html

UnitedHealthcare uses evidence-based clinical guidelines from nationally recognized sources during review of our quality and health management programs. …

Policies and Protocols for Providers | UHCprovider.com

https://www.uhcprovider.com/en/policies-protocols.html

Clinical Guidelines. Dental Clinical Policies and Coverage Guidelines. Requirements for Out-of-Network Laboratory Referral Requests. Protocols. UnitedHealthcare …

Criteria for Imaging - eviCore

https://www.evicore.com/-/media/files/evicore/clinical-guidelines/solution/cardiology-and-radiology/archive/uhc-oxford-cardiology_v202018_eff-11212018_pub9162018.pdf

VII. Non-imaging Heart Function and Cardiac Shunt Imaging VIII. Genetic lab testing in the evaluation of CAD 78459 PET Myocardial – Metabolic 19 78491 PET Myocardial …

NCD - Positron Emission Tomography (PET) Scans (220.6)

https://www.cms.gov/medicare-coverage-database/view/ncd.aspx?NCDId=211

Item/Service Description. Effective January 1, 2022, the Centers for Medicare & Medicaid Services removed the umbrella national coverage determination (NCD) for …

Commercial Policy Benefits Plans for Providers

https://www.uhcprovider.com/en/policies-protocols/commercial-policies.html

UnitedHealthcare Affiliates Commercial Policies: UnitedHealthcare® Oxford Clinical and Administrative Policies; UnitedHealthcare® West Benefit Interpretation Policies; …

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