CurrentColorado Rocky Mountain Health PlansPolicy CSRAD010OH.D
UN-CSRAD010OH.D - Adult Oncology Imaging Guidelinesopen_in_new
State-specific (Ohio) UnitedHealthcare Community Plan guidelines V1.0.2025 for adult oncology-related advanced imaging and imaging procedure coding, indications, and utilization management; covers modality-specific guidance (US, CT, MRI, PET), documentation requirements, investigational determinations, and selected billing guidance for image-guidance and 3D rendering codes. This is part 1 of 19 and contains preface/general guidelines and selected coding/billing rules.
Policy Summary
PayerColorado Rocky Mountain Health Plans
PolicyUN-CSRAD010OH.D - Adult Oncology Imaging Guidelinesopen_in_new
Policy CodePolicy CSRAD010OH.D
Change TypeAnnual and interim evidence-based updates (2024-2025)
Effective DateNov 1, 2025
Next Review Date
Key ActionProviders must submit a recent detailed history, physical exam, labs, prior imaging and other pertinent records to establish medical necessity per condition-specific guidelines.
SourceLink
POLICY UPDATE CHANGES
02/01/2024, Summary of Changes = Annual evidence-based updates.
07/01/2024, Summary of Changes = Interim evidence-based updates.
05/01/2025, Summary of Changes = Annual evidence-based updates.
V1.0.2025Guideline Version
OhioGeographic Scope
2025-11-01Effective Date
SeveralSupported PET radiotracers
Policy Summary
PayerColorado Rocky Mountain Health Plans
PolicyUN-CSRAD010OH.D - Adult Oncology Imaging Guidelinesopen_in_new
Policy CodePolicy CSRAD010OH.D
Change TypeAnnual and interim evidence-based updates (2024-2025)
Effective DateNov 1, 2025
Next Review Date
Key ActionProviders must submit a recent detailed history, physical exam, labs, prior imaging and other pertinent records to establish medical necessity per condition-specific guidelines.
SourceLink
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