UnitedHealthcare policy
Outpatient Cardiology Procedures for EviCore Arrangement (for Oxford Only) – Oxford Medical Policy
Outpatient Cardiology Procedures for EviCore Arrangement (for Oxford Only) – Oxford Medical Policy is a public UnitedHealthcare policy (policy CARDIOLOGY 025.28, effective Sep 1, 2026). It lists 33 CPT or HCPCS codes. Not a coverage decision; the payer's own document governs.
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- Payer
- UnitedHealthcare
- Policy number
- CARDIOLOGY 025.28
- Effective
- Sep 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 |
|---|---|
| 0571T | Policies naming 0571T |
| 0614T | Policies naming 0614T |
| 0742T | Policies naming 0742T |
| 75557 | Policies naming 75557 |
| 75559 | Policies naming 75559 |
| 75561 | Policies naming 75561 |
| 75563 | Policies naming 75563 |
| 75571 | Policies naming 75571 |
| 75572 | Policies naming 75572 |
| 75573 | Policies naming 75573 |
| 75574 | Policies naming 75574 |
| 75577 | Policies naming 75577 |
| 75580 | Policies naming 75580 |
| 78451 | Policies naming 78451 |
| 78452 | Policies naming 78452 |
| 78453 | Policies naming 78453 |
| 78454 | Policies naming 78454 |
| 78459 | Policies naming 78459 |
| 78491 | Policies naming 78491 |
| 78492 | Policies naming 78492 |
| 93350 | Policies naming 93350 |
| 93351 | Policies naming 93351 |
| 93451 | Policies naming 93451 |
| 93452 | Policies naming 93452 |
| 93453 | Policies naming 93453 |
| 93454 | Policies naming 93454 |
| 93455 | Policies naming 93455 |
| 93456 | Policies naming 93456 |
| 93457 | Policies naming 93457 |
| 93458 | Policies naming 93458 |
| 93459 | Policies naming 93459 |
| 93460 | Policies naming 93460 |
| 93461 | Policies naming 93461 |
All UnitedHealthcare policies · UnitedHealthcare prior authorization CPT list