October 7, 2020 at 7:00 PM CT

COVID-19 Temporary Provision Updates

UnitedHealthcare is updating a number of temporary provisions for telehealth originating site requirements and cost share waivers. Review the Summary of COVID-19 Dates by Program for details.

COVID-19 Informational Videos

Last update: May 5, 2020, 11:45 p.m. CDT

National Nurses Week

Please watch this short thank you message from all of us at UnitedHealthcare

[00:00:00] Dr. Anne Docimo: [00:00:00] Over the years, I've learned so much from nurses about clinical care and caring. Thanks for everything.

[00:00:12] Dr. Darshak Sanghavi: [00:00:12] Thank you so much to all of our nurses for all that you do every day for our members to keep them healthy.

[00:00:19] Dr. Margaret-Mary Wilson: [00:00:19] The sacrifices you have made for the hard work, the passionate dedication you have shown. As we have collectively worked our way through the COVID 19 [00:00:30] pandemic.

[00:00:30] Dr. Stephen Cha: [00:00:30] I got some great advice early on. It's never steered me wrong. Always listen to your nurses. Thanks for everything you do.

[00:00:36] Dr. Rhonda Randall: [00:00:36] We are honored to serve alongside you in our joint mission. Happy nurses week.

Updates from UnitedHealthcare

Billing for COVID-19 Office Visits:  Guidance on how to bill for initial COVID-19 office visits, from Tim Kaja, Chief Operating Officer, UnitedHealthcare Networks.

Tim Kaja – How Practices Bill Detailed Video Transcript

[UnitedHealthcare logo]

[Covid-19 Provider Update: Office Billing for Initial Coronavirus Test]

[How should practices bill for the Coronavirus (COVID-19) office visits?]

[Tim Kaja, Chief Operating Officer, UnitedHealthcare Networks]

We want to thank everyone for their continued patience around coding protocols as they continue to evolve for the coronavirus and coronavirus testing.

In this edition, we're going to talk specifically about how the primary care physician bills for the coronavirus test when the patient presents in an in-office setting.

Our guidance continues to be informed by the American Medical Association and their CPT code experts.

When the patient presents to the physician’s office with symptoms of the coronavirus, the physician should bill the appropriate evaluation and management code consistent with the level of history, exam and medical decision-making made.

The swab and the submission of the coronavirus test is included in the evaluation and management code.

The ICD-10 codes submitted are consistent with the reason why the patient visited the physician and the diagnosis but also includes whether or not the patient had previous confirmed exposure to coronavirus, or only suspected exposure to someone with coronavirus.

If it's the former, bill ICD-10 code Z20.828

[Actual exposure to COVID-19]

If it's only suspected exposure to coronavirus, bill ICD-10 code Z03.818.

[Possible exposure to COVID-19]

We know these are difficult times and at UnitedHealthcare, we're attempting to create clarity in claim submission processes. In this case, for how to bill for the coronavirus when the patient presents in an in-office setting.

This information can also be found on UHCprovider.com

[UnitedHealthcare logo]

uhcprovider.com

We have sought guidance and input from AMA CPT® committee in the development of all billing scenarios. Information provided by the American Medical Association does not dictate payer reimbursement policy, and does not substitute for the professional judgement of the practitioner performing a procedure, who remains responsible for correct coding.

Billing for COVID-19 Laboratory Tests: Information on how to bill for COVID-19 testing, from Tim Kaja, Chief Operating Officer, UnitedHealthcare Networks

Tim Kaja Detailed Video Transcript

[UnitedHealthcare logo]

[Covid-19 Provider Update: Lab Billing for Coronavirus Test]

[How should labs bill for the Coronavirus (COVID-19) test?]

[Tim Kaja, Chief Operating Officer, UnitedHealthcare Networks]

During these times of uncertainty, I’d like to focus on how UnitedHealthcare is creating clarity around coding practices for health care professionals billing for the coronavirus test.

Specifically, laboratories as they bill for the coronavirus test.

We had an opportunity to confer with the American Medical Association, their CPT experts, and the Federation of Medicine a short while ago.

When billing from a laboratory for the coronavirus test, you’ll need to remember one CPT code and two ICD-10 codes.

You may have heard previously that there was a distinction as to whether or not the test kit was provided by the CDC or not.

We are no longer recognizing that distinction.

So, the correct CPT code to bill is the new CPT code 87635 for all laboratory tests being submitted for the coronavirus test.

On the ICD-10 code, follow the diagnoses that were submitted by the participating physician who submitted the test.

And that will be consistent with whether or not the patient had previous confirmed exposure to someone with coronavirus or only suspected exposure to someone with coronavirus.

If it’s the former, bill with ICD-10 code Z20.828.

[Actual exposure to COVID-19]

If the patient has only been suspected of having contact with someone with coronavirus, go with ICD-10 code Z03.818.

[Possible exposure to COVID-19]

We know that these are difficult times and at UnitedHealthcare, we are attempting to create clarity in claims submission processes. 

In this case, for billing of a coronavirus test from a laboratory.

This information can also be found on UHCprovider.com

[UnitedHealthcare logo]

uhcprovider.com

We have sought guidance and input from AMA CPT® committee in the development of all billing scenarios. Information provided by the American Medical Association does not dictate payer reimbursement policy, and does not substitute for the professional judgement of the practitioner performing a procedure, who remains responsible for correct coding.

Tips for Using Telehealth to See Patients: Learn how to get started with telehealth and tips on making the most out of your telehealth experience

[UnitedHealthcare logo]

[Provider Update: Tips for Using Telehealth to See Your Patients]

[Anupam Goel, M.D.]

The COVID-19 pandemic creates an opportunity for many of us in primary care to adopt telehealth to help manage our patients. Many encounters meeting the criteria for evaluation and management may be eligible for reimbursement by UnitedHealthcare during this emergency period. 

[Chose videoconferencing technology]

To start using telehealth to see your patients, first choose a videoconferencing technology. There is no requirement to integrate the technology into your EMR system. With the recent decision by Health and Human Services to waive enforcement of HIPAA penalties against providers serving their patients in good faith during the crisis, many common, everyday technologies may be acceptable. And just recently, UnitedHealthcare approved audio-only interactions for the same codes that are included within the existing telehealth scope for many services. Check UHCprovider.com and the guidance from Health and Human Services to see what works best for your situation. Don’t forget, physical therapy, occupational therapy and speech therapy require interactive video and audio to be reimbursed.

[Ensure patient health insurance covers telehealth]

Second, make sure the patient’s health insurance covers telehealth visits. This verification may be easier to perform at the end of a face-to-face visit in anticipation of the next visit. During this national emergency, we’re processing benefits according to the member’s plan.

[Schedule appointment]

Third, schedule the appointment in the way that also updates your back-office staff, since they will be submitting the claim after the appointment. Before the appointment, have your staff verify the patient’s ability to use the videoconferencing platform and determine what information you might need to collect from the patient prior to your appointment.  Your staff might do this in a variety of ways, including reaching out to the patient by email or phone.

[Complete visit]

Fourth, complete your visit. When you document the encounter, detail the reason why the visit was conducted via telehealth along with the member’s consent to have the visit using telehealth.

[Submit claim]

Finally, submit the claim with the relevant billing code, place of service and telemedicine modifiers, as appropriate. UnitedHealthcare’s telehealth reimbursement policies during the COVID-19 emergency can be found by going to UHCprovider.com and clicking on the COVID-19 banner at the top of the page.

This is a fast-moving, ever-changing situation for all of us. Please check the relevant Health and Human Services as well as UnitedHealthcare general telehealth and COVID-19-specific websites for the most up-to-date information, including eligible billing codes and modifiers.

[Disclaimer: This is a video intended for informational purposes only and is not intended to provide instructions or legal guidance on telehealth coverage or reimbursement. For further information, please visit www.UHCprovider.com.]

[UnitedHealthcare logo]

uhcprovider.com

UnitedHealthcare Operations: Mike Baker, Chief Operating Officer, Provider Operations, highlights that our operations and systems are fully operational.

UnitedHealthcare logo]

[Covid 19 Provider Update Operational Performance]

[Mike Baker, Chief Operating Officer, UnitedHealthcare Provider]

First and most importantly, I’d like to offer a very sincere thank you on behalf of everyone here at UnitedHealthcare Operations for taking care of our members and taking care of our families.

And just as you’re reacting to this very dynamic situation it changes minute by minute, I’d like to reassure you that so are we.

Across all of our core operating activities, whether it’s set up, our call centers and our claim processing activities, we are meeting all of our service commitments and standards right now.

All of our systems, including our online portals like LINK are up and running just fine.

Should anything change, know that we’ll let you know right here at UHC provider.com but until then, once again thank you.

[UnitedHealthcare logo]

Uhcprovider.com

Disclaimer:

The benefits and processes described on this website apply pursuant to federal requirements and UnitedHealthcare national policy during the national emergency.  Additional benefits or limitations may apply in some states and under some plans during this time.

We will adjudicate benefits in accordance with the member’s health plan.

Medicaid Providers: UnitedHealthcare will reimburse out-of-network providers for COVID-19 testing-related visits and COVID-19 related treatment or services according to the rates outlined in the Medicaid Fee Schedule.

We’re listening.

We’re committed to keeping you up to date on COVID-19 – we’re monitoring your inquiries and working hard to answer your questions. Let us know how we’re doing.

We’ll be making daily updates to this site. Be sure to check back often for the latest information.