UnitedHealthcare will begin requiring a full written interpretation and report to reimburse the professional component of certain radiology services billed alongside evaluation and management visits, effective April 1.
Here are four things to know:
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.
2. The report must align with American College of Radiology guidelines, according to a Jan. 2 notice from the insurer.
3. 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.
4. UnitedHealthcare notified impacted providers of this change in an issue of their Network News under reimbursement policy updates on Jan. 2.
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