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- UnitedHealthcare Announces Physicians Need to Submit Z-Codes with CPT Codes Starting Feb. 1
On November 1, UnitedHealthcare notified the CAP that physicians will need to begin submitting the Z-Code with the CPT code beginning Feb. 1, 2025, for Medicaid plans. They are working with providers offering assistance as they register for Z-Codes. They also are reaching out to providers with reminders and status updates. Information about how to obtain a Z-Code and the status of the provider’s registration can be found at the following link: DEX (dexzcodes.com). The list of CPT codes can be found here: DEX test code registry phase list - UnitedHealthcare commercial plans (uhcprovider.com).
The CAP has opposed this requirement for specific Z-code identifiers on claims to receive payment. In a letter dated May 31, 2024, the CAP urged UnitedHealthcare to reconsider the new requirements claiming they are needlessly disruptive, burdensome, and financially demanding for pathologists and impede patient access to medically necessary testing.
Additionally, UnitedHealthcare is expanding the use of Z-Codes for certain molecular diagnostic test services on facility and professional claims to its Medicaid benefit plans. Providers may begin registering tests that are in scope for phase 1 of the Z-Codes for their Medicaid implementation now. As a reminder, if providers have already registered their tests as part of the Medicare or commercial benefit plan implementation, they will not need to register again and can use the same Z-Code and CPT code combination for Medicaid plans.
Providers with questions or who need assistance should email united_genetics@uhc.com.