gPM Clients: Messages from Practice Insight: UHC Payers CPT Rejections (Jan. 23, 2018)


Practice Insight received the following notification regarding claim rejections of UnitedHealthcare payers for valid CPT codes starting January 01, 2018.

EDI Claims Rejecting in Error for Procedure Code effective January 1, 2018

OptumInsight and UnitedHealth Group have identified an issue that is causing electronic data interchange (EDI) claims with new procedure codes (CPT, NDC, HCPC) effective on January 1, 2018 to reject in error. The error message will reflect Code is not a valid CPT or HCPCS Code for this Date of Service.

OptumInsight and UnitedHealth Group will have all January 1 effective codes available for claims to process on February 2, 2018. At this time, we would recommend halting submission of EDI claims with new procedure codes effective January 1, 2018 until the codes are updated for processing use on 2/2/18. Claims with procedure codes effective before January 1, 2018 will process as normal.