P2P Call Guide

How to Win a P2P Call for Total Hip Replacement Denied by UHC

Payer-specific strategy, medical necessity arguments, and the exact phrases to use when UnitedHealthcare denies Total Hip Replacement (CPT 27130).

Why UHC Denies Total Hip Replacement

Conservative management not exhausted

BMI exceeds payer threshold (often >40)

Imaging does not show severe joint disease

Know UnitedHealthcare's Criteria

UHC uses InterQual criteria and their own Clinical UM Guidelines (CG series). Medical directors are typically accessible for P2P within 5 business days.

Key policies to know:

  • Requires eviCore for MSK and advanced imaging prior auth
  • Clinical UM Guidelines (CG series) are publicly available online
  • Prior auth through Optum/UHG portal
  • Known for strict step therapy requirements on biologics

Building Your Medical Necessity Argument

Document Kellgren-Lawrence grade on imaging

Show failure of NSAIDs, PT, injections, activity modification

Note functional limitations using validated outcome measures

Address BMI and optimization if applicable

P2P Call Tips for UHC

Reference UHC's own Clinical UM Guideline number (e.g., CG-SURG-71)

UHC medical directors respond well to InterQual criteria language

Be specific about which InterQual subset applies

Have the CG policy number ready -- shows you've done your homework

Guidelines to Reference

  • AAOS Clinical Practice Guidelines for Hip OA
  • MCG Criteria for Total Joint Replacement

Relevant CPT Codes

CPT 27130

Specialty: Orthopedics

Want the full strategy?

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