Billing Beat

Radiology Multiple Imaging Reduction Policy- Policy Revision to Eliminate Eleven Diagnostic Imaging Families

March 29, 2011

Effective with claims submitted with a date of service on or after June 1, 2011, UnitedHealthcare will adopt the changes in the CMS 2011 multiple imaging reduction payment policy. With this revision, UnitedHealthcare will align with the CMS’s multiple imaging payment methodology and treat the services as if they were from a single diagnostic imaging family. The 50 percent imaging reduction will be applied to the allowable amount for the technical component of multiple imaging procedures reported in the same patient session that are considered second and/or subsequent. These changes will apply to all codes that have a CMS multiple procedure indicator of 4 on the CMS National Physician Fee Schedule (NPFS).

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