UHC Community Plan Implements Inappropriate Primary Diagnosis Policy

UnitedHealthcare (UHC) Community plan has implemented a new inappropriate primary diagnosis policy with an effective date of June 1, 2021. This new policy will deny claims where an inappropriate diagnosis is in box 67 on a UB-04 claim form or its electronic equivalent. This policy is being implemented in 20 states and will impact outpatient physical, occupational and speech therapy services. To access this policy, click

New ICD-10-CM Codes Take Effect October 1, 2020

The Centers for Medicare and Medicaid Services (CMS) has released ICD-10-CM for Fiscal Year (FY) 2021 on their website. These 2021 ICD-10-CM codes are to be used for discharges occurring from October 1, 2020 through September 30, 2021 and for patient encounters occurring from October 1, 2020 through September 30, 2021. To access the FY 2021 ICD-10-CM new, revised and deleted ICD-10-CM codes effective October 1, 2020, click HERE. To access the files from the CMS website, click HERE.