UnitedHealthcare adds new reporting hurdle for radiology reimbursement

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UnitedHealthcare is updating its reimbursement policy for radiology services billed with evaluation and management services for dates of service on or after April 1.

Beginning April 1, when the same provider bills both an E/M service and a global radiology code for the same patient on the same day, UnitedHealthcare will require a full written interpretation and report to separately reimburse the professional component of the radiology service, according to a Jan. 2 notice from the insurer. The report must align with American College of Radiology guidelines.

If the radiology service and the E/M service are billed by different providers, UnitedHealthcare will not require a separate report submission for reimbursement. However, documentation should still be maintained in the medical record.

UnitedHealthcare notified impacted providers of this change in an issue of their Network News under reimbursement policy updates on January 2.

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