UnitedHealthcare Radiology Program Procedure Code Changes

October 2018 ~

UnitedHealthcare (UHC) is updating its procedure code list for the Radiology Notification and Prior Authorization programs to include a set of temporary codes related to Coronary Fractional Flow Reserve Using Computed Tomography (FFR-CT).

The following Category III CPT codes are being added to UHC’s Radiology Notification and Prior Authorization list, effective January 1, 2019. Claims with dates of service on or after this date (01/01/2019) are subject to these changes.

Code: 0501T

Code Description: Noninvasive estimated coronary fractional flow reserve (FFR) derived from coronary computed tomography angiography data using computation fluid dynamics physiologic simulation software analysis of functional data to assess the severity of coronary artery disease; data preparation and transmission, analysis of fluid dynamics and simulated maximal coronary hyperemia, generation of estimated FFR model, with anatomical data review in comparison with estimated FFR model to reconcile discordant data, interpretation and report. 

Code: 0502T

Code Description: Noninvasive estimated coronary fractional flow reserve (FFR) derived from coronary computed tomography angiography data using computation fluid dynamics physiologic simulation software analysis of functional data to assess the severity of coronary artery disease; data preparation and transmission. 

Code: 0503T

Code Description: Noninvasive estimated coronary fractional flow reserve (FFR) derived from coronary computed tomography angiography data using computation fluid dynamics physiologic simulation software analysis of functional data to assess the severity of coronary artery disease; analysis of fluid dynamics and simulated maximal coronary hyperemia, and generation of estimated FFR model.

Code: 0504T

Code Description: Noninvasive estimated coronary fractional flow reserve (FFR) derived from coronary computed tomography angiography data using computation fluid dynamics physiologic simulation software analysis of functional data to assess the severity of coronary artery disease; anatomical data review in comparison with estimated FFR model to reconcile discordant data, interpretation and report.

Source(s): UnitedHealthcare Network Bulletin October 2018;