UnitedHealthcare policy

Outpatient Radiology Procedures for EviCore Arrangement (for Oxford Only) – Oxford Medical Policy

Outpatient Radiology Procedures for EviCore Arrangement (for Oxford Only) – Oxford Medical Policy is a public UnitedHealthcare policy (policy RADIOLOGY 037.42, effective Sep 1, 2026). It lists 171 CPT or HCPCS codes. Not a coverage decision; the payer's own document governs.

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Payer
UnitedHealthcare
Policy number
RADIOLOGY 037.42
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.

CodeOther UnitedHealthcare policies
0174TPolicies naming 0174T
0175TPolicies naming 0175T
0609TPolicies naming 0609T
0610TPolicies naming 0610T
0611TPolicies naming 0611T
0612TPolicies naming 0612T
0633TPolicies naming 0633T
0634TPolicies naming 0634T
0635TPolicies naming 0635T
0636TPolicies naming 0636T
0637TPolicies naming 0637T
0638TPolicies naming 0638T
0697TPolicies naming 0697T
0698TPolicies naming 0698T
0710TPolicies naming 0710T
0711TPolicies naming 0711T
0712TPolicies naming 0712T
0713TPolicies naming 0713T
0865TPolicies naming 0865T
0866TPolicies naming 0866T
70336Policies naming 70336
70450Policies naming 70450
70460Policies naming 70460
70470Policies naming 70470
70471Policies naming 70471
70472Policies naming 70472
70473Policies naming 70473
70480Policies naming 70480
70481Policies naming 70481
70482Policies naming 70482
70486Policies naming 70486
70487Policies naming 70487
70488Policies naming 70488
70490Policies naming 70490
70491Policies naming 70491
70492Policies naming 70492
70496Policies naming 70496
70498Policies naming 70498
70540Policies naming 70540
70542Policies naming 70542
70543Policies naming 70543
70544Policies naming 70544
70545Policies naming 70545
70546Policies naming 70546
70547Policies naming 70547
70548Policies naming 70548
70549Policies naming 70549
70551Policies naming 70551
70552Policies naming 70552
70553Policies naming 70553
70554Policies naming 70554
70555Policies naming 70555
71250Policies naming 71250
71260Policies naming 71260
71270Policies naming 71270
71271Policies naming 71271
71275Policies naming 71275
71550Policies naming 71550
71551Policies naming 71551
71552Policies naming 71552
71555Policies naming 71555
72125Policies naming 72125
72126Policies naming 72126
72127Policies naming 72127
72128Policies naming 72128
72129Policies naming 72129
72130Policies naming 72130
72131Policies naming 72131
72132Policies naming 72132
72133Policies naming 72133
72141Policies naming 72141
72142Policies naming 72142
72146Policies naming 72146
72147Policies naming 72147
72148Policies naming 72148
72149Policies naming 72149
72156Policies naming 72156
72157Policies naming 72157
72158Policies naming 72158
72159Policies naming 72159
72191Policies naming 72191
72192Policies naming 72192
72193Policies naming 72193
72194Policies naming 72194
72195Policies naming 72195
72196Policies naming 72196
72197Policies naming 72197
72198Policies naming 72198
73200Policies naming 73200
73201Policies naming 73201
73202Policies naming 73202
73206Policies naming 73206
73218Policies naming 73218
73219Policies naming 73219
73220Policies naming 73220
73221Policies naming 73221
73222Policies naming 73222
73223Policies naming 73223
73225Policies naming 73225
73700Policies naming 73700
73701Policies naming 73701
73702Policies naming 73702
73706Policies naming 73706
73718Policies naming 73718
73719Policies naming 73719
73720Policies naming 73720
73721Policies naming 73721
73722Policies naming 73722
73723Policies naming 73723
73725Policies naming 73725
74150Policies naming 74150
74160Policies naming 74160
74170Policies naming 74170
74174Policies naming 74174
74175Policies naming 74175
74176Policies naming 74176
74177Policies naming 74177
74178Policies naming 74178
74181Policies naming 74181
74182Policies naming 74182
74183Policies naming 74183
74185Policies naming 74185
74261Policies naming 74261
74262Policies naming 74262
74263Policies naming 74263
75635Policies naming 75635
76376Policies naming 76376
76377Policies naming 76377
76380Policies naming 76380
76390Policies naming 76390
76391Policies naming 76391
76497Policies naming 76497
76498Policies naming 76498
76499Policies naming 76499
76975Policies naming 76975
77021Policies naming 77021
77046Policies naming 77046
77047Policies naming 77047
77048Policies naming 77048
77049Policies naming 77049
77084Policies naming 77084
78429Policies naming 78429
78430Policies naming 78430
78431Policies naming 78431
78432Policies naming 78432
78433Policies naming 78433
78466Policies naming 78466
78468Policies naming 78468
78469Policies naming 78469
78472Policies naming 78472
78473Policies naming 78473
78481Policies naming 78481
78483Policies naming 78483
78494Policies naming 78494
78496Policies naming 78496
78499Policies naming 78499
78579Policies naming 78579
78608Policies naming 78608
78609Policies naming 78609
78811Policies naming 78811
78812Policies naming 78812
78813Policies naming 78813
78814Policies naming 78814
78815Policies naming 78815
78816Policies naming 78816
78830Policies naming 78830
C8937Policies naming C8937
G0235Policies naming G0235
G0252Policies naming G0252
S8037Policies naming S8037
S8080Policies naming S8080

All UnitedHealthcare policies · UnitedHealthcare prior authorization CPT list

Disclaimer

The information provided on this page is for general informational purposes only and does not constitute billing, coding, or reimbursement advice. Nothing on this page should be relied upon as a substitute for clinician assessment, professional billing guidance, or as a definitive statement of any payor's billing requirements or policies.

Payor agreements, fee schedules, and billing policies vary and are subject to change. Before submitting any claims related to maternity care services, including claims affected by the 2027 CPT code revisions, please consult the applicable payor agreements, coverage policies, and billing guidelines to confirm current requirements for their specific payor contracts.

Substrate makes no representation or warranty regarding the accuracy, completeness, or timeliness of the payor-specific information presented here. Providers are solely responsible for ensuring that all claims are submitted in accordance with applicable payor requirements, and Substrate assumes no liability for claim denials, underpayments, or other adverse outcomes arising from reliance on this information.