UnitedHealthcare Commercial Reimbursement Policy Updates

April 17, 2021
Rick Gawenda

Effective with dates of service on or after 9/1/2020, the Outpatient Hospital Correct Coding Initiative (CCI) Editing policy will apply to all network and non-network hospitals. In addition, the policy will apply to all outpatient types of bills that are applicable to these edits. Click HERE to read the announcement straight from UnitedHealthcare.

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  1. appreciate the update Rick. in NY (we are an outpatient PT/OT provider) UHC/Oxford is still denying claims for edit pairs that were removed in the 2021 update. i want to make sure i am interpreting UHCs Bulletin correctly by assuming i do not need to resubmit these claims with a 59 modifier billed post Sept 1, 2020. Thank you