decisionhealth Newsletters, Coder Pink Sheets - 2019 Issue 7 (July)
New coding guidance: UnitedHealthcare puts office, inpatient consults on the chopping block
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Article Overview
This article covers a UnitedHealthcare commercial policy update phasing out coverage of consultation service codes and discussing how providers may need to adjust reporting for evaluation and management services. It is relevant to billing staff, coders, and revenue cycle teams that work with commercial payer policies, especially where consult coverage, network bulletins, and fee schedule methodology changes affect claim submission. The article also places the change in context by referencing prior bulletin activity and related Oxford policy materials.
Why This Topic Matters
Payer policy changes can affect how consultation-related visits are reported and reimbursed. Understanding the scope and timing of this update helps practices monitor commercial payer requirements and anticipate claim-processing impacts.
What You Will Learn
- The scope of a commercial payer policy update affecting consultation service coverage
- The timing and phased nature of the change discussed in the article
- The broader reimbursement and fee schedule context referenced by the payer
- How prior bulletin activity is used to frame the policy update
- What types of resources are cited for further reference
Who Should Read This
- Medical coders
- Billing specialists
- Revenue cycle staff
- Practice managers
- Compliance staff
Codes Discussed
Code Ranges Discussed
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