Billing Beat

UHC – Preventive Care Services Update 9/1/2020

September 9, 2020

Applicable Codes Preventive Care Services

Revised coverage guidelines for Hepatitis C Virus Infection Screening:

  • Updated service description:
    • Removed June 2013 USPSTF “B” rating
    • Added March 2020 USPSTF “B” rating to indicate the USPSTF recommends screening for hepatitis C virus infection in adults aged 18 to 79 years o Removed list of applicable diagnosis codes
  • Updated preventive benefit instructions:

    • Removed reference links to the Hepatitis C Virus Infection Diagnosis Code list

    • Added language to indicate hepatitis C virus infection screening does not have diagnosis code requirements for the preventive benefit to apply

Preventive Vaccines (Immunizations)

Added CPT code 90697 for diphtheria, tetanus toxoids, acellular pertussis, inactivated poliovirus vaccine, haemophilus influenza type B PRP-OMP conjugate, and hepatitis B (DTaP-IPV-Hib-HepB)

  • Trade name: Vaxelis
  • Age group: Pediatric
  • Benefit limit: Ages 0-4 years (ends on 5th birthday

Supporting Information Archived previous policy version CDG.016.32.

Source: https://www.uhcprovider.com/content/dam/provider/docs/public/policies/index/commercial/preventive-care-services-09012020.pdf

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