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Prostate Surgeries and Interventions

Prostate Surgeries and Interventions Page 1 of 21 UnitedHealthcare Commercial Medical Policy Effective 05/01/2022 Proprietary Information of UnitedHealthcare. Copyright 2022 United HealthCare Services, Inc. UnitedHealthcare Commercial Medica l Policy Prostate Surgeries and Interventions Policy Number: 2022T0618C Effective Date: May 1, 2022 Instructions for Use Table of Contents Page Coverage Rationale .. 1 Documentation Requirements .. 2 Applicable Codes .. 3 Description of Services .. 4 Clinical 4 Food and Drug 17 References .. 18 Policy History/Revision Information .. 21 Instructions for 21 Coverage Rationale Transurethral ablation of the Prostate is proven and medically necessary in certain circumstances. For medical necessity clinical coverage criteria, refer to the InterQual 2022, Apr.

Prostate Surgeries and Interventions Page 1 of 21 UnitedHealthcare Commercial Medical Policy Effective 11/01/2021 ... Benefit coverage for health services is determined by the member specific benefit plan document and applicable laws that may require coverage for a specific service. The inclusion of a code does not imply any right to ...

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