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- CAP Advocacy Win: UnitedHealthcare to Indefinitely Delay Requirements for Z-Codes
The CAP and UnitedHealthcare had a meeting on August 3, to discuss the planned update to the insurer’s molecular pathology policy, professional and facility reimbursement, previously announced on May 1, 2023.
Following the meeting, UnitedHealthcare made the decision to delay the new molecular pathology policy to ensure that those providers who have not yet taken steps to register applicable tests or have not yet completed the registration process have additional time to do so and to receive Z-codes for use in submitting claims. They will announce the new effective date prior to publication of the policy. In advance of the new effective date, providers are encouraged to begin submitting Z-codes on their claims.
Claims will not be denied if they do not contain a Z-code. However, continued submission of the Z-codes will provide time to ensure compliance when the policy goes into effect and may lead to fewer requests for information. To be prepared for the policy’s publication, providers should continue to register their Phase 1 tests and complete the steps to obtain a Z-code. Providers who have questions or need assistance should email united_genetics@uhc.com.
UnitedHealthcare said in a letter to the CAP, “We value your engagement and appreciate your partnership as we strive toward our shared missions of improving healthcare delivery. We appreciate the opportunity to discuss the policy and our reasoning for requesting providers submit Z-codes for the molecular diagnostic tests they perform. We also value the resulting dialogue.”