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The Network Bulletin is a bimonthly online/email publication featuring important protocol and policy changes, as well as useful administrative information and clinical resources. For archives of past Network Bulletins, select a link from the left navigation. Not receiving the Network Bulletin via email? Sign up today!
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| (03/19/2008) | | Network Bulletin - March 2008 
Reimbursement Policy - Contrast Materials, Unusual Services, Laboratory Rebundling, Obstetrical Ultrasound Policy Retirement, Tendon Sheath and Ligament, Ganglion Cyst, Carpal and Tarsal Tunnel Injections Coding, Trigger Point Injections Coding, Nerve Conduction Studies/ Electromyography Coding , Obstetrical Anesthesia Services with/Time-Based Reimbursement Clarification, Audiologic/Vestibular Function Testing, Radioallergosorbent (RAST) Type Tests, Urodynamics Coding, Respiratory Therapy Services Coding, Viral Hepatitis Serology Testing Coding , Facet Joint Injections Reimbursement Coding; Medical Policy - Chiropractic Services Update, Nerve Conduction Studies (NCS) and Electromyography (EMG) Clarification, Cluster Headache: Surgical Treatment Drug-eluting Stents for Treatment of Coronary Artery Disease, Excimer Laser for Ophthalmic Procedures, Mechanical Insufflation-Exsufflation Therapy for RespiratoryInsufficiency, Rapid Diagnostic Tests for Influenza, Robotic-Assisted Surgery, Treatment for Plagiocephaly and Craniosynostosis, Ultrasonography for the Diagnosis and Management of Back Pain and Radiculopathies; Claims - Billing Tips for Claims for Consumer Driven Plans, Electronic Payer ID Update, Regional Mail Office Change for Claim Address Change for Evercare and SecureHorizons Business Managed Through Certain San Antonio Addresses – Effective 1/1/2008, New and Improved Claim Letters Debut in April; Drug Policy - Maximum Dosage Drug Policy Effective 3/15/2008, Revised Policy for palivizumab (Synagis®) Effective 1/1/2008, UnitedHealthcare to use NCCN Drugs and Biologics Compendium to Determine Whether Chemotherapy Drugs are Proven or Unproven Effective 3/15/2008; Pharmacy Updates - Specialty Pharmacy Referral Line Serves as Resource for Prescribing Physicians; Protocol Updates - Pregnancy Notification Requirement; Clinical Resources - OptumHealth Education: Free CME Activities, Clinical Resources; e-Business Updates - UnitedHealthcareOnline Tips March 2008, Electronic Payments and Statements (EPS) Broadens its Reach and Benefits Coming in April – UnitedHealthcare Connectivity Director, Training Schedules, Claim Estimator Combined with Real-Time Adjudication; Take Note - 2008 Administrative Guide Effective 4/1/2008, National Provider Identifier (NPI), Reminder – Imaging Accreditation Program Implementation Date Extended, Merck Announces Vaccine Price Increase, UnitedHealth Group Acquires Sierra Health Services; Articles for Additional - UnitedHealthcare Entities, UnitedHealthcare Services Company of the River Valley, Inc.; Appendix ICD-9 Codes for Injections into the Tendon Sheath and Ligament, Ganglion Cyst, Carpal and Tarsal Tunnel Policy, ICD-9 Codes for Audiologic/Vestibular Function Testing ICD-9 Codes for Radioallergosorbent (RAST) Type Tests.
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| (01/14/2008) | | Network Bulletin - January 2008
Reimbursement Policy - Changes to Multiple Procedure Policy, Age and Gender to Diagnosis Code, • ICD-9 Filtering Policy for Facet Joint Injections, Split Surgical Package Policy, Viral Hepatitis Serology Testing Policy, Audiologic/Vestibular Function Testing Policy, Obstetrical Policy, Clarification on Same Provider Definition Within Reimbursement Policies, Telemedicine Policy – Routine Coding, Nerve Conduction Studies Electromyography, Transforaminal Epidural Injections Policy, Respiratory Therapy Services, Same Day Same Service Policy, Time Span, Obstetrical Ultrasound Policy; Medical Policy - Drug-eluting Stents for Treatment of Coronary Artery Disease, Home Hemodialysis, Lung Volume Reduction Surgery, Nebulized Antibiotic Therapy for Chronic Sinusitis, Screening for Cervical Cancer Claims, Claim Issue Causing Inappropriate Denials with Remark Codes O9, O7, O6 and Q9; Drug Policy - National Comprehensive Cancer Network Compendium, Claim Dosage Error Policy for Injectable Drugs; Pharmacy Updates - Prescription Drug List Changes, 2007 Pharmacy Rider; Protocol Updates - Admission Notification Update – Acute Care Hospitals, Skilled Nursing Facilities and Acute Rehabilitation Facilities; Clinical Resources - New Renal Stone Prevention Program; e-Business Updates - UnitedHealthcareOnline Tips, Coming Soon – UnitedHealthcare Connectivity Director, Working to Better Serve Billing Companies, Access Patient Personal Health Records, Unsure if your Patient is in a Consumer Driven Health Plan?, Go Green with UnitedHealthcare!; Take Note - New Drug Pricing Alternate Fee Source, Nasally-Administered Influenza Vaccine, Certificate of Coverage, UnitedHealthcareOnline Scorecard, Total Choice Plans, National Provider Identifier (NPI), Coding Update to Facility Outpatient Procedure Grouper Mapping, Imaging Accreditation Program Implementation, Tiered Benefit Plans, UnitedHealthcare Acquires Fiserv Health.
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| (11/21/2007) | | Network Bulletin - November 2007
Reimbursement Policy - Multiple Procedure Policy, Revised ICD-9 Filtering Policies for Viral Hepatitis Serology Testing and RAST Type Tests, Osmolar Contrast Materials Policy Update, Anesthesia Policy Revisions, Obstetrical Policy Revisions, Revised ICD-9 Filtering Policy for Polysomnography; Medical Policy - Chest X-Ray Policy Implementation Postponed, CAD for MammographyImplementation Postponed, Chiropractic Services Policy for Treatment of Children & Adolescents, and Treatment of Headaches Suspended; Protocols - Advance and Admission Notification Reminder, Pregnancy Notification Requirement, PM&R ServicesNotification Program Effective in CO and FL; Claims - Primary Physician/Specialist Coding Update to July Article; Clinical Resources - Asthma CME Course; e-Business Updates - UnitedHealthcare Online Tips, Online Claims Estimator, UnitedHealthcare Connectivity Director Coming in '08; Take Note - New Drug Pricing Alternate Fee Source, Communication of Diabetic Dilated Retinal Exam Results to Primary Physician, Communication of Discharge Summaries to Primary Physician, '08 Health Care Codes and Reimbursement Policy Schedule, Reminder – Patient Access Standards, National Influenza Vaccination Week, Obtain Imaging Accreditation by March 1, 2008, NPI, Refer a Patient to the Heart Failure Program, Promoting Quality and Professional Development, CPT Code Crosswalk Table for Radiology Notification Updated, UnitedHealthcare Signs Agreement to Acquire Fiserv Health. |
| (09/25/2007) | | Network Bulletin - September 2007
Reimbursement Policy - ICD-9 Filtering for Audiologic/Vestibular, Function Test Services, Osmolar Contrast Materials, Global Days, Bilateral Procedures, CMS National Correct Coding Initiative (CCI) Edits, Preventive Medicine and Screening, Time Span, Obstetrical Ultrasound, Delay in Reimbursement Policy Enhancements; Medical Policy Update and Benefit Reminder - CPT and Nerve Conduction Studies, Arthroscopic Lavage and Debridement for Osteoarthritis of the Knee, Chiropractic Services, Computer-aided Detection for Mammography, Computerized Gait Analysis for Cerebral Palsy, Spina Bifida and Orthopedic Disorders, Electrocardiography, Evoked Potentials Testing and Intraoperative Monitoring, High-Frequency Chest Wall Compression and Respiratory Devices, Oral-Pharyngeal Tissue Reduction for Treatment of OSA, Percutaneous Alcohol Ablation, Radiofrequency Ablation for Spinal and Orthopedic Pain, Unicompartmental Knee Replacement, Total Artificial Disc; Claims - Electrocardiography Claim Adjustments, Incorrect Submission in Loop 2010AA and 2010AB for Segment NM1, Data Elements NM102/NM103 of the 837 Professional Claim Transaction May Cause Delays in Payment; Pharmacy Updates - New PDL; eBusiness Updates - UnitedHealthcare Online® Tips, Electronic Payments & Statements, New Claim Estimator Tool, Electronic Solutions, Designed to Fit Your Needs; Take Note - Data Quality, UnitedHealthcare Insight Survey, United Behavioral Health – Atlanta Sends ADHD Educational Materials to Members, PM&R Services Notification, NPI, Radiology Notification CPT Code Crosswalk, New Benefit Plans, America on the Move!, Additional UnitedHealthcare Entities - Arnett Health Plans, UnitedHealthcare Student Resources and UnitedHealthcare Services Company of the River Valley. |
| (07/09/2007) | | Network Bulletin - July 2007
Reimbursement policy - Same Day Same Service, Preventive Medicine/Screening update, Rebundling, Care Plan Oversight, National CCI Edits, Time Span Codes; Claims - Primary Care Physician/Specialist Coding Issue; eBusiness updates - Enroll in Electronic Payments and Statements (EPS), Real Time Adjudication, Claim Estimator; Take note - Requirements for Initiation of Practitioner Credentialing, Physician/Healthcare Provider Service Update, National Provider Identifier (NPI), Imaging Accreditation, Certificate of Coverage, PacifiCare HMO Prior Authorization List – CPT and HCPCS Codes, California Network Participants: Payer Summary Disclosure, Choice Plus Network Access for State of CT Oxford Plan Members, Promoting Quality and Professional Development. |
| (05/15/2007) | | Network Bulletin - May 2007
Reimbursement Policy- Updated Split Surgical Package, Multiple Procedure, Lab Rebundling-Venipuncture Section-Revised, Bilateral Procedures-Update, Add-On-Update; Medical Policy Update and Benefit Reminder- MRS is Unproven for Brain Tumors and Epilepsy, Foot Care Benefit for Fully Insured Members; Claims- NPI Update, Primary Care Physician/Specialist Coding, Mammography Coding, CMS – Correction to CPT Code 77055; Protocol Update - Implantable Cardiac Defibrillators CPT Procedure Codes; Pharmacy Updates - PDL Changes, Albuterol Transition; eBusiness Updates - Update your Practice Information, EPS and NPI, Web site enhancements, Claims Adjudication, Real Time Adjudication; Take Note - Payer Summary Disclosure for CA, Culturally Competent Care, Credentialing, United Medical Resources (UMR) Accessing Options PPO Network, Asthma Program, Chronic Kidney Disease, Hypertensive Treatment of Diabetic Patients, America on the Move!
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| (04/25/2007) | | Network Bulletin - April 2007
Reimbursement Policies: Physical Medicine & Rehabilitation (PM&R), Supervised Modalities – Update to Sept. 2006 Network Bulletin, Assistant Surgeon Policy - Update to March 2007 Network Bulletin, B Bundle Codes Policy, Moderate Sedation Policy – Revised, Revisions to the ICD-9 Filtering Policy for Audiologic and Vestibular Function Tests, Obstetrical (OB) Ultrasound, New Acupuncture and Evaluation, Management Services Policy, Professional/Technical Component Policy Revisions, Therapeutic and Diagnostic Injection Policy; Medical Policy: Chest x-Rays for Screening; Claims: Anesthesia Claims: Reporting in Minutes vs. Units; Benefit Coverage for New Treatment for Uterine Fibroids.
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| (03/13/2007) | | Network Bulletin - March 2007
Pregnancy Notification Requirement; Reimbursement Policies; Half Tablet Program; Imaging Accreditation Reminder; Diabetes information; Blood Pressure Success Zone Pilot; Integrity of Claims, Reports and Representations To Government Entities; EPS Update; New Claims Summarization Enhancement; Erythropoietin (EPO) Drug Policy Change Effective April 2; System Issue with the Radiology Multiple Imaging Reduction Policy; Sharing Lab Results with Patients; UnitedHealthcare Online updates; Consumer Driven Health Plan Membership growing; Payer Summary Disclosure for CA; Integration of Hydroxyprogesterone (17P) Administration for OB/GYN; 2007 Benefit Coverage Update; New Benefit Coverage for Clinical Trials; Lab Network Updates; NPI; High Ranking in Athena Health Survey; 2007-2008 Administrative Guide Effective April 1.
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| (01/23/2007) | | Network Bulletin - January 2007
New/revised medical and reimbursement policies; 2007 Prescription Drug List; Imaging Accreditation Requirement; New Drug Pricing Initiative; Delay in Service – Hospital Stays Claims Update; Erythropoeitin Claims Update; New Claim Summarization Enhancement; Enrolled in Electronic Payments & Statements; National Provider Identifier (NPI); Credentialing That Sets a New Standard; Payer Summary for CA; Changes to our Laboratory Service Provider Network; and more. |
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