Updated documentation used for cardiac ablation procedure reviews

Beginning Jan. 1, 2026, health care professionals requesting prior authorizations for cardiac ablation procedures, CPT® codes 93653, 93656, may need to submit additional documents. No new codes are being added to the prior authorization list.

This change applies to UnitedHealthcare commercial plans, UnitedHealthcare® Medicare Advantage Plans and certain Medicaid states with existing prior authorization requirements for these codes.

Documentation details

You may need to include the following medical notes with the prior authorization request:

Diagnosis as documented by electrocardiogram (ECG), Holter or rhythm strip
Recent physical exam within the last 3 months
Signs and symptoms including date of onset, duration and frequency and whether the arrhythmia is symptomatic, paroxysmal, and/or persistent
Reports on all recent imaging studies and applicable diagnostics, including:
- Electrolytes within the last 6 months
- Thyroid-stimulating hormone within the last 12 months
- Assessment for myocardial ischemia, e.g. stress test within the last 12 months
- Left ventricular ejection fraction by echocardiography or multigated acquisition
Treatments tried, failed or contraindicated. Include the dates, duration and reason for discontinuation.
Physician treatment plan

How to submit a prior authorization

Sign in to the UnitedHealthcare Provider Portal with your One Healthcare ID
- If you don’t have a One Healthcare ID, register now
From the left-hand tabs, select Prior Authorizations & Notifications