Prosthetic Devices, Wigs, Specialized, Microprocessor or ...

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Prosthetic devices , wigs , specialized , Microprocessor or myoelectric Limbs Page 1 of 21 UnitedHealthcare Commercial Coverage Determination Guideline Effective 01/01/2022 Proprietary Information of UnitedHealthcare. Copyright 2022 United HealthCare Services, Inc. UnitedHealthcare Commercial Cover a ge Deter mina tion Guideline Prosthetic devices , wigs , specialized , Microprocessor or myoelectric Limbs Guideline Number: Effective Date: January 1, 2022 Instructions for Use Table of Contents Page Coverage Rationale ........................................ ............................... 1 Documentation Requirements ........................................ .............. 5 Definitions.

Prosthetic Devices, Wigs, Specialized, Microprocessor or Myoelectric Limbs Page 3 of 21 UnitedHealthcare Commercial Coverage Determination Guideline Effective 01/01/2022 Proprietary Information of UnitedHealthcare.

  Devices, Specialized, Prosthetic, Microprocessor, Limb, Wigs, Prosthetic devices, Microprocessor or myoelectric limbs, Myoelectric