UnitedHealthcare policy
Breast Reconstruction
Breast Reconstruction is a public UnitedHealthcare policy (policy MP.003.29, effective Jan 1, 2026). It lists 33 CPT or HCPCS codes. Not a coverage decision; the payer's own document governs.
View the original policy (PDF) ↗
Check eligibility for free
No account required. Sign a BAA to see plan details, coordination of benefits and more
- Payer
- UnitedHealthcare
- Policy number
- MP.003.29
- Effective
- Jan 1, 2026
- Line of business
- Commercial
- Source
- www.uhcprovider.com
Codes in this policy
The CPT and HCPCS codes the policy names. A policy can name a code it excludes. Open official prior authorization lists to check the member’s product.
| Code | Other UnitedHealthcare policies |
|---|---|
| 11920 | Policies naming 11920 |
| 11921 | Policies naming 11921 |
| 11922 | Policies naming 11922 |
| 11970 | Policies naming 11970 |
| 11971 | Policies naming 11971 |
| 15271 | Policies naming 15271 |
| 15272 | Policies naming 15272 |
| 15771 | Policies naming 15771 |
| 15772 | Policies naming 15772 |
| 15777 | Policies naming 15777 |
| 19316 | Policies naming 19316 |
| 19325 | Policies naming 19325 |
| 19328 | Policies naming 19328 |
| 19330 | Policies naming 19330 |
| 19340 | Policies naming 19340 |
| 19342 | Policies naming 19342 |
| 19350 | Policies naming 19350 |
| 19355 | Policies naming 19355 |
| 19357 | Policies naming 19357 |
| 19361 | Policies naming 19361 |
| 19364 | Policies naming 19364 |
| 19367 | Policies naming 19367 |
| 19368 | Policies naming 19368 |
| 19369 | Policies naming 19369 |
| 19370 | Policies naming 19370 |
| 19371 | Policies naming 19371 |
| 19396 | Policies naming 19396 |
| 19499 | Policies naming 19499 |
| L8600 | Policies naming L8600 |
| S2066 | Policies naming S2066 |
| S2067 | Policies naming S2067 |
| S2068 | Policies naming S2068 |
| S8950 | Policies naming S8950 |
All UnitedHealthcare policies · UnitedHealthcare prior authorization CPT list