UnitedHealthcare Updated Z-Code Requirements for Molecular Diagnostic Testing – DEX DX Exchange

UnitedHealthcare updated its FAQs for its Z-code requirements as part of its phased implementation. Beginning on August 1, 2024, labs were able to start registering tests that are in scope for phase 2 of the DEX Z-Codes® for certain molecular diagnostic test services on facility and professional claims. This is part of UnitedHealthcare’s recently updated Molecular Pathology Reimbursement Policy, Professional and Facility, which went into effect June 1, 2024.

Tests subject to phase 2 will need to include the appropriate Z-Code on their claims beginning with dates of service on or after November 1, 2024, to be considered for reimbursement. You can find more information at dexzcodes.com or download the bulletin below.

Source: https://www.uhcprovider.com/content/dam/provider/docs/public/prior-auth/genetics/Z-Code-Requirements-DEX-DX-Exchange.pdf