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United piles on more coding to already exhausted and overwhelmed providers

On September 23, 2020, Health Leaders reported that United is adding new coding requirements for freestanding and outpatient lab claims, despite knowing their importance for COVID-19 response. See why critics are raising red flags on this new United policy.

In September, UnitedHealthcare released a plan that will require all in-network freestanding and outpatient lab claims to include a unique code for testing services. This code is in addition to existing standard CPT codes. If providers do not add these new codes to their lab claims, United says they will be rejected. Regardless of the reasoning behind this policy, which is not clear from media coverage, the reality is that it will add a significant administrative burdens to providers during a time when they are already stretched thin due to the ongoing COVID-19 pandemic. The burden is so large, in fact, that the American Hospital Association released a public statement expressing concerns about the policy itself, as well as the limited amount of time providers have to implement it. The policy is set to go into effect on January 1, right in the middle of what is anticipated to be an especially challenging flu season due to COVID-19. Concerns are so strong that hospitals and labs are being encouraged to consider filing formal objections with United. But will they have the bandwidth to do this? Perhaps a better question is, why should they have to?

Original Article:

With resources already strained due to the ongoing novel coronavirus (COVID-19) pandemic, some organizations might not be able to comply, the AHA cautions in its letter.

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