The purpose of this policy is to reimburse units billed for outpatient hospital services without reimbursing for obvious billing submission and data entry errors or incorrect coding based on anatomic considerations, Healthcare Common Procedure Coding System II (HCPCS)/Current Procedural Terminology CPT® (CPT) code descriptors, CPT coding instructions, established UnitedHealthcare Value & Balance Exchange policies, nature of a service/procedure, nature of an analyte, nature of equipment, and unlikely clinical treatment. In those instances where Grouping of services applies, the number of units submitted should be equally divisible by the number of days indicated in the 'from' and 'to' dates reported. Grouping is allowed only for identical services on consecutive days. When Grouping services, the place of service, procedure code, charges, and individual provider for each line must be identical for that service line. WEB Detail Reason and Posting Date Desiredįrom - To Date Policy, Professional - Reimbursement Policy - UnitedHealthcare Medicare Advantage Plans Reimbursement policy, review not required. WEB Reason Why Provider Communication Review Not Required Provider Communication Review Not Required WEB Name of Alternate Contact or Content Owner
Standard form 5510 medicare update#
Note: for instructions to Content Managers, Word formats are acceptable.įor Large Volume Requests Only: If you are requesting an update to more than five documents, please download and fill out the XLS template provided below and attach completed XLS file using the "Add Documents" feature above.ĭownload Large Volume Request XLS Template >
Any other document format must be approved as an exception (.xls.
Standard form 5510 medicare pdf#
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