AMA Clinical Examples in Radiology - 2011 Bulletin 1
UnitedHealthcare to Reduce Payment for Cross-Modality Contiguous Imaging
UnitedHealthcare to Reduce Payment for Cross-Modality Contiguous Imaging Beginning with dates of service on or after June 1, 2011, UnitedHealthcare is reducing by 50 percent the technical component payment of multiple imaging procedures reported during the same patient session that are considered second and/or subsequent. The new UnitedHealthcare policy mirrors the changes in the Centers for Medicare and Medicaid Services' (CMS') multiple procedure payment reduction policy. These changes apply to all codes that have a CMS multiple procedure indicator of "four" on the National Provider Fee Schedule (NPFS). The American College of Radiology (ACR) commented to UnitedHealthcare that these...
Subscribe or sign in to view the full article.
Article Overview
This article reviews a UnitedHealthcare policy change related to payment reductions for contiguous imaging performed in a single patient session. It explains the policy’s timing, its relationship to CMS payment reduction methodology, and the professional commentary surrounding the change. The content is relevant to radiology coders, billing staff, and compliance professionals who track imaging reimbursement updates and payer policy shifts.
Why This Topic Matters
Policy changes affecting imaging reimbursement can alter claim payment patterns and affect radiology revenue cycle processes. Understanding which procedures are subject to payer-specific multiple procedure reductions helps coding and billing teams monitor reimbursement impacts and stay aligned with payer rules.
What You Will Learn
- The scope of the UnitedHealthcare policy update affecting imaging payment.
- How the policy relates broadly to CMS multiple procedure payment reduction methodology.
- The professional response to the payer update and why it drew attention in radiology circles.
- The effective date and general applicability of the policy change.
Who Should Read This
- Radiology coders
- Medical billers
- Revenue cycle staff
- Compliance professionals
- Imaging practice managers
Subscribe or sign in to view the full article.
Quick, Current, Complete - www.findacode.com
