UnitedHealthcare Announces Policy Updates

UnitedHealthcare’s plans to retire two reimbursement policies in the first quarter of 2010 have been postponed. Reimbursement policies for Facet Joint Injections and Transforaminal Epidural Injections remain in effect until further notice.

Several other medical polices were given more immediate attention. Effective March 1, UnitedHealthcare has adopted a new policy of noncoverage for transcranial magnetic stimulation (TMS) for treatment of any condition.

TMS is reported with CPT® Category III codes 0160T Therapeutic repetitive transcranial magnetic stimulation treatment planning and 0161T Therapeutic repetitive transcranial magnetic stimulation treatment delivery and management, per session.

Effective May 1, UnitedHealthcare is revising its Epidural Steriod and Facet Injections for Spinal Pain policy. Changes include applicable ICD-9-CM diagnosis code additions and revised coverage rationale.

UnitedHealthcare also is revising coverage rationale, effective March 1, for the following  medical policies:

  • Hyperthermic Chemotherapy,
  • Repair of Pectus Deformities, and
  • Stereotactic Radiosurgery.

Additionally, several policy titles were changed, several drug policies were revised, and the following policies were retired:

  • Electrical and Ultrasound Bone Growth Stimulators (Nov. 30, 2009)
  • Metacarpophalangeal and Proximal Interphalangeal Joint Implant (Jan. 1)

See UnitedHealthcare’s January 2009 Network Bulletin for details.

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One Response to “UnitedHealthcare Announces Policy Updates”

  1. Alice Morgan says:

    Where does it stop? Humana, Inc. has incorporated many policy changes effective Jan 2010 and April 2010. Would these companies want to work for free. Can we continue to allow them to dictate our care and what is covered! Why isn’t Government spending monitored / controlled in the same manner as healthcare?

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