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Coverage Rationale Applicable Codes - UHCprovider.com

Prolotherapy and Platelet Rich Plasma Therapies Page 1 of 24 UnitedHealthcare Commercial Medical Policy Effective 01/01/2022 Proprietary Information of UnitedHealthcare. Copyright 2022 United HealthCare Services, Inc. UnitedHealthcare Commercial Medica l Policy Prolotherapy and Platelet Rich Plasma Therapies Policy Number: 2022T0498V Effective Date: January 1, 2022 Instructions for Use Table of Contents Page Coverage Rationale .. 1 Applicable Codes .. 1 Description of Services .. 2 Clinical Evidence .. 2 Food and Drug Administration.

painful joints and connective tissue. Prolotherapy is injection of any substance (i.e., dextrose, saline, sarapin and procaine or lidocaine) that promotes growth of normal cells, tissues, or organs by stimulating the body’s natural healing mechanisms to lay …

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