Category III CPT Codes - UHCprovider.com

Category III CPT Codes Page 1 of 29 UnitedHealthcare Medicare Advantage Policy Guideline Approved 12/08/2021 Proprietary Information of UnitedHealthcare. Copyright 2021 United HealthCare Services, Inc. UnitedHealthcare Medicare Advantage Policy Guideline Category III CPT Codes Guideline Number: Approval Date: December 8, 2021 Terms and Conditions Table of Contents Page Policy Summary .. 1 Applicable Codes .. 2 Questions and Answers .. 17 References .. 17 Guideline History/Revision Information .. 28 Purpose .. 28 Terms and Conditions .. 29 Policy Summary See Purpose Overview The American Medical Association (AMA) develops temporary Current Procedural Terminology (CPT) Category III Codes to track the utilization of emerging technologies, services, and procedures. The Category III CPT code description does not establish a service or procedure as safe, effective or applicable to the clinical practice of medicine.

Furnished at a level, duration, or frequency that is not medically appropriate; Not furnished in accordance with accepted standards of medical practice; or Not furnished in a setting appropriate to the patient's medical needs and condition. Items and services must be established as safe and effective to be considered medically necessary.

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  Code, Category, Medically, Necessary, Cpt category iii codes, Medically necessary

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