UHC Medical Policy updates
October 13, 2020Policy Title, Status, Effective Date
- Computer-Assisted Surgical Navigation for Musculoskeletal Procedures Revised Nov. 1, 2020
- Electric Tumor Treatment Field Therapy Revised Dec. 1, 2020
- Gender Dysphoria Treatment Revised Nov. 1, 2020
- Genetic Testing for Hereditary Cancer Revised Dec. 1, 2020
- Genitourinary Pathogen Nucleic Acid Detection Panel Testing Updated Oct. 1, 2020
- Implanted Electrical Stimulator for Spinal Cord Updated Oct. 1, 2020
- Lower Extremity Invasive Diagnostic and Endovascular Procedures Revised Dec. 1, 2020
- Pharmacogenetic Testing Updated Oct. 1, 2020
- Plagiocephaly and Craniosynostosis Treatment Updated Oct. 1, 2020
Reimbursement Policy Update Bulletin Laboratory Services Policy
- Effective with dates of service on or after January 1, 2021, UnitedHealthcare will align with CMS and require surgical pathology for prostate needle biopsy specimens, including gross and microscopic examination, be reported with HCPCS code G0416 instead of 88305.
- According to the CMS National Correct Coding Initiative (NCCI) Manual (Chapter 10), CMS requires that surgical pathology for all prostate needle biopsy specimens, including gross and microscopic examination, be reported with 1 unit of service and code G0416, instead of code 88305 and multiple units of service.
- Claims for surgical pathology for prostate needle biopsy that do not align with the Laboratory Services Policy enhancement, because they are reported with code 88305, will be denied.