Deprecated: Creation of dynamic property Cookie_Law_Info_Cli_Policy_Generator::$plugin_name is deprecated in /nas/content/live/ahsrcmprod/wp-content/plugins/cookie-law-info/legacy/admin/modules/cli-policy-generator/cli-policy-generator.php on line 176

Deprecated: Use of "self" in callables is deprecated in /nas/content/live/ahsrcmprod/wp-content/plugins/cookie-law-info/legacy/includes/class-cookie-law-info.php on line 604

Deprecated: Creation of dynamic property WPCF7R_Base::$plugin_path is deprecated in /nas/content/live/ahsrcmprod/wp-content/plugins/wpcf7-redirect/classes/class-wpcf7r-base.php on line 28

Deprecated: Creation of dynamic property WPCF7R_Base::$version is deprecated in /nas/content/live/ahsrcmprod/wp-content/plugins/wpcf7-redirect/classes/class-wpcf7r-base.php on line 30

Deprecated: Creation of dynamic property WPCF7r_Settings::$page_slug is deprecated in /nas/content/live/ahsrcmprod/wp-content/plugins/wpcf7-redirect/classes/class-wpcf7r-settings.php on line 18

Deprecated: Creation of dynamic property Qs_Api::$activation_url is deprecated in /nas/content/live/ahsrcmprod/wp-content/plugins/wpcf7-redirect/classes/class-qs-api.php on line 15

Deprecated: Creation of dynamic property Qs_Api::$changelog_url is deprecated in /nas/content/live/ahsrcmprod/wp-content/plugins/wpcf7-redirect/classes/class-qs-api.php on line 16

Deprecated: Creation of dynamic property Qs_Api::$api_url is deprecated in /nas/content/live/ahsrcmprod/wp-content/plugins/wpcf7-redirect/classes/class-qs-api.php on line 17

Deprecated: Creation of dynamic property Qs_Api::$store_id is deprecated in /nas/content/live/ahsrcmprod/wp-content/plugins/wpcf7-redirect/classes/class-qs-api.php on line 18

Deprecated: Creation of dynamic property Qs_Api::$sku is deprecated in /nas/content/live/ahsrcmprod/wp-content/plugins/wpcf7-redirect/classes/class-qs-api.php on line 19

Deprecated: Creation of dynamic property Qs_Api::$extensions_list_url is deprecated in /nas/content/live/ahsrcmprod/wp-content/plugins/wpcf7-redirect/classes/class-qs-api.php on line 20

Deprecated: Creation of dynamic property Qs_Api::$promotions_url is deprecated in /nas/content/live/ahsrcmprod/wp-content/plugins/wpcf7-redirect/classes/class-qs-api.php on line 21

Deprecated: Creation of dynamic property WPCF7r_Settings::$api is deprecated in /nas/content/live/ahsrcmprod/wp-content/plugins/wpcf7-redirect/classes/class-wpcf7r-settings.php on line 19

Deprecated: Creation of dynamic property WPCF7R_Base::$wpcf_settings is deprecated in /nas/content/live/ahsrcmprod/wp-content/plugins/wpcf7-redirect/classes/class-wpcf7r-base.php on line 43

Deprecated: Creation of dynamic property Qs_Api::$activation_url is deprecated in /nas/content/live/ahsrcmprod/wp-content/plugins/wpcf7-redirect/classes/class-qs-api.php on line 15

Deprecated: Creation of dynamic property Qs_Api::$changelog_url is deprecated in /nas/content/live/ahsrcmprod/wp-content/plugins/wpcf7-redirect/classes/class-qs-api.php on line 16

Deprecated: Creation of dynamic property Qs_Api::$api_url is deprecated in /nas/content/live/ahsrcmprod/wp-content/plugins/wpcf7-redirect/classes/class-qs-api.php on line 17

Deprecated: Creation of dynamic property Qs_Api::$store_id is deprecated in /nas/content/live/ahsrcmprod/wp-content/plugins/wpcf7-redirect/classes/class-qs-api.php on line 18

Deprecated: Creation of dynamic property Qs_Api::$sku is deprecated in /nas/content/live/ahsrcmprod/wp-content/plugins/wpcf7-redirect/classes/class-qs-api.php on line 19

Deprecated: Creation of dynamic property Qs_Api::$extensions_list_url is deprecated in /nas/content/live/ahsrcmprod/wp-content/plugins/wpcf7-redirect/classes/class-qs-api.php on line 20

Deprecated: Creation of dynamic property Qs_Api::$promotions_url is deprecated in /nas/content/live/ahsrcmprod/wp-content/plugins/wpcf7-redirect/classes/class-qs-api.php on line 21

Deprecated: Creation of dynamic property WPCF7R_Base::$wpcf7_redirect is deprecated in /nas/content/live/ahsrcmprod/wp-content/plugins/wpcf7-redirect/classes/class-wpcf7r-base.php on line 45

Deprecated: Creation of dynamic property Qs_Api::$activation_url is deprecated in /nas/content/live/ahsrcmprod/wp-content/plugins/wpcf7-redirect/classes/class-qs-api.php on line 15

Deprecated: Creation of dynamic property Qs_Api::$changelog_url is deprecated in /nas/content/live/ahsrcmprod/wp-content/plugins/wpcf7-redirect/classes/class-qs-api.php on line 16

Deprecated: Creation of dynamic property Qs_Api::$api_url is deprecated in /nas/content/live/ahsrcmprod/wp-content/plugins/wpcf7-redirect/classes/class-qs-api.php on line 17

Deprecated: Creation of dynamic property Qs_Api::$store_id is deprecated in /nas/content/live/ahsrcmprod/wp-content/plugins/wpcf7-redirect/classes/class-qs-api.php on line 18

Deprecated: Creation of dynamic property Qs_Api::$sku is deprecated in /nas/content/live/ahsrcmprod/wp-content/plugins/wpcf7-redirect/classes/class-qs-api.php on line 19

Deprecated: Creation of dynamic property Qs_Api::$extensions_list_url is deprecated in /nas/content/live/ahsrcmprod/wp-content/plugins/wpcf7-redirect/classes/class-qs-api.php on line 20

Deprecated: Creation of dynamic property Qs_Api::$promotions_url is deprecated in /nas/content/live/ahsrcmprod/wp-content/plugins/wpcf7-redirect/classes/class-qs-api.php on line 21

Deprecated: Creation of dynamic property WPCF7r_Utils::$api is deprecated in /nas/content/live/ahsrcmprod/wp-content/plugins/wpcf7-redirect/classes/class-wpcf7r-utils.php on line 23

Deprecated: Creation of dynamic property WPCF7R_Base::$wpcf7_utils is deprecated in /nas/content/live/ahsrcmprod/wp-content/plugins/wpcf7-redirect/classes/class-wpcf7r-base.php on line 47

Deprecated: Creation of dynamic property WPCF7R_Base::$wpcf7_submission is deprecated in /nas/content/live/ahsrcmprod/wp-content/plugins/wpcf7-redirect/classes/class-wpcf7r-base.php on line 49

Deprecated: Creation of dynamic property WPCF7R_Base::$wpcf7_user_panel is deprecated in /nas/content/live/ahsrcmprod/wp-content/plugins/wpcf7-redirect/classes/class-wpcf7r-base.php on line 51

Deprecated: version_compare(): Passing null to parameter #2 ($version2) of type string is deprecated in /nas/content/live/ahsrcmprod/wp-content/plugins/Ultimate_VC_Addons/Ultimate_VC_Addons.php on line 1272

Deprecated: ctype_digit(): Argument of type null will be interpreted as string in the future in /nas/content/live/ahsrcmprod/wp-content/mu-plugins/wpe-cache-plugin/cache-control.php on line 174

Deprecated: Use of "self" in callables is deprecated in /nas/content/live/ahsrcmprod/wp-content/plugins/cookie-law-info/legacy/includes/class-cookie-law-info.php on line 604
UHC Genetic and Molecular Lab Testing Prior Authorization Requirement

UHC Genetic and Molecular Lab Testing Prior Authorization Requirement

April 2019 ~

Effective July 1, UnitedHealthcare (UHC) will expand the existing prior authorization/notification for genetic and molecular testing performed in an outpatient setting to UnitedHealthcare Plan of the River Valley, Inc., UnitedHealthcare Insurance Company of the River Valley, MAMSI Life and Health Insurance Company, Optimum Choice, Inc., MD Individual Practice Association, Inc. and UnitedHealthcare self-insured plans.

According to the notice, providers are instructed to use the Genetic and Molecular Test tool on Link to submit the notification/ prior authorization request. Next, providers will be asked to fill in the member’s information and choose the test and the lab to perform the test. Ordering providers will need to submit requests for tests that require authorization. Labs may submit their own notification requests for tests that only require notification.

The following will require notification/prior authorization:

  • Tier 1 Molecular Pathology Procedures
  • Tier 2 Molecular Pathology Procedures
  • Genomic Sequencing Procedures
  • Multianalyte Assays with Algorithmic Analyses that include Molecular Pathology Testing
  • The following CPT codes:
  • 0001U,
  • 0012U – 0014U,
  • 0016U – 0019U,
  • 0022U – 0023U,
  • 0026U – 0034U,
  • 0036U – 0037U,
  • 0040U,
  • 0045U – 0050U,
  • 0055U – 0057U,
  • 0060U,
  • 0069U – 0076U,
  • 0078U,
  • 0081U,
  • 0004M,
  • 0006M – 0007M,
  • 0009M,
  • 0011M – 0013M,
  • 81105 – 81111,
  • 81120 – 81121,
  • 81161 – 81210,
  • 81215 – 81420,
  • 81425 – 81479,
  • 81507,
  • 81518 – 81521,
  • 81545,
  • 81595 – 81599,
  • S3870

UHC notes that BRCA prior authorization requirements will not change with this expansion.

 

CPT® is a registered trademark of the American Medical Association.

 

Source(s): UnitedHealthcare Network Bulletin April 2019;

 

 

 

AdvantEdge
AdvantEdge