P2P Call Guide

How to Win a P2P Call for Shoulder Arthroscopy / Rotator Cuff Repair Denied by UHC

Payer-specific strategy, medical necessity arguments, and the exact phrases to use when UnitedHealthcare denies Shoulder Arthroscopy / Rotator Cuff Repair (CPT 29827, 29826, 23412).

Why UHC Denies Shoulder Arthroscopy / Rotator Cuff Repair

Conservative therapy not exhausted (PT, injections)

Partial tear does not meet surgical threshold

Imaging does not correlate with symptoms

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 tear size and location on MRI

Show failure of 3-6 months PT and at least one subacromial injection

Note functional limitations and pain severity

Reference full-thickness tear or significant partial tear (>50%)

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 Rotator Cuff
  • AIM Specialty Health Shoulder Surgery Guidelines

Relevant CPT Codes

CPT 29827CPT 29826CPT 23412

Specialty: Orthopedics

Want the full strategy?

The P2P Playbook covers payer-specific approaches for Shoulder Arthroscopy / Rotator Cuff Repair denied by UHC -- plus 15 denial objections with word-for-word responses, what reviewers are actually thinking, and the 60-second prep framework. Written by a medical director who reviewed cases for major payers.

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