United Health Care Bundles Anesthesia for Pain Injections
By: Bellinger P. Moody, RHIA, CPC, CCP, CPC-I
Executive Vice President of Compliance
February 10, 2011
Effective Immediately, United Health Care (UHC) uses the CMS National Correct Coding Initiative (NCCI) edits when considering procedural or pain management services that are an integral part of anesthesia management services (CPT codes 00100 – 01999 excluding 01996 and 01953) and anesthesia management services that are an integral part of the procedural or pain management services. The CMS NCCI edits are managed under the United Healthcare “CCI Editing Policy.”
The policy addresses the following procedural or pain management services that are not separately payable to the same physician or other healthcare professional on the same date of service with anesthesia management services:
- Anesthesia services provided and billed for CPT codes 62310, 62311, 62318, 62319, 64400, 64402, 64405, 64408, 64410, 64412, 64413, 64415, 64416, 64417, 64418, 64420, 64421, 64425, 64430, 64435, 64445, 64446, 64447, 64448, 64449, 64450, 64505, 64508, 64510, 64517, 64518, 64530, 64479, 64480, 64483, 64484, 64490, 64491, 64492, 64493, 64494, and 64495 will be denied as not separately payable.
As a result of this new UHC policy, Medac can no longer bill anesthesia for the above listed pain services to United Healthcare. Please be sure to consider this policy in your practice as you provide these services to the patients that have United Healthcare as their health insurer.
The information presented herein reflects general information that is current as of the date it was first published. In light of changes that may occur in the health care regulatory and compliance environments, the author's presentation of this information might become outdated. Please check with your individual legal and/or compliance advisor(s) prior to taking any significant actions based upon the information and advice presented.