- Home
- Advocacy
- Latest News and Practice Data
- UnitedHealthcare Implements Phase 2 of Z-code Requirement
Despite objections from the CAP, UnitedHealthcare will implement phase 2 of its Z-code requirement. Tests subject to phase 2 will need to include the appropriate Z-code on claims beginning with dates of service on or after November 1, 2024, to be considered for reimbursement.
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.
UnitedHealthcare requires providers to submit the appropriate unique test identifier (DEX Z-Code®) and appropriate CPT code for Molecular Diagnostic Tests (MDT) and other molecular pathology services. More information about the Palmetto DEX Z-Code® and how to obtain one can be found at https://app.dexzcodes.com.
Impacted laboratories that need assistance can contact the insurer at united_genetics@uhc.com.