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UHC Payer Update

APS wants to make you aware of a recent denial trend impacting multiple states. Beginning January 1, 2019, United Healthcare began denying CPT 88141 (Physician Reviewed PAP Smear) when billed by itself.  The denials included dates of service from 2018 and 2019.  United Healthcare Representatives advised that, per Policy Number 2018R0071E, CPT 88141 was considered an add-on code effective 01/01/19.  The policy states that the primary CPTs are Cytotechnologist Reviewed PAP Smear codes: 88142, 88143, 88147, 88148, 88150, 88152, 88153, 88164, 88165, 88166, 88167, 88174, and 88175.
 
APS’ Denial Management Team advised UHC that 88141 was categorized as an add-on code in error.  APS then reached out to multiple Provider Relations Representatives for affected states.  We received response back from a Senior Provider Relations Advocate in Illinois and a FAST Field Analyst for the Central Region, who reviewed example denials.  On April 15, 2019, we received confirmation that UHC placed a fix in their system for this issue as a company-wide project and providers do not need to call in to UHC or contact their advocates.  They also advised that all affected claims are being sent back for reprocessing and to expect payment within 60 days. 

APS will continue to monitor this and all denial issues to ensure clients are paid for their rendered services.

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