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OptumInsight Notification:

ICD-10 Code Edits Applied by UnitedHealthcare

From: Pennie, Rachel E [mailto:rachel.pennie@optum.com]
Sent: Monday, July 20, 2015 10:08 AM
To: undisclosed-recipients:
Subject: OptumInsight System Notification: UNITEDHEALTHCARE SYSTEM NOTIFICATION-Medicare Complete Northern Utah

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Date / Time (Time Zone): July 20, 2015 11:07 AM MDT

UNITEDHEALTHCARE SYSTEM NOTIFICATION

Date:  7/20/2015

ICD-10 Code Edits Applied By UnitedHealthcare

Oct. 1, 2015 is the compliance date for the transition to ICD-10 coding to replace ICD-9. These codes are used by physicians and health care professionals to record and identify diagnoses and procedures for claims payments. ICD-10 affects diagnosis and inpatient procedure coding only. It does not affect current procedural terminology (CPT) coding for outpatient procedures.

ICD-10 edits currently in place are shown in the grid below, subject to change prior to Oct 1. Please refer to the Enhanced Claim Editssection of UnitedHealthcareOnline.com for the complete list of edits applied by UnitedHealthcare.

Based on ANSI X12 TR3 compliance regulations, WEDI SNIP Types indicated are enhanced at a pre-adjudication level during HIPAA validation. This enables UnitedHealthcare claim submitters to identify and correct rejected information prior to the claim’s acceptance into our adjudication system for processing.

Please encourage your users to check claim submission reports on a regular basis and in a timely manner. They can view tracking your electronic claims to learn more about electronic reports and rejections. The UnitedHealthcare ICD-10 websitecontains many tools and resources to assist submitters with the transition to ICD-10.

If you have any questions, please contact Electronic Data Interchange (EDI) Support:

*Exceptions:  Harvard Pilgrim (04271), Medica HealthCare Plans (78857), Preferred Care Partners (65088), The Alliance (88461) and TRICARE West (99726)

Thank you,

UnitedHealthcare

If you have further questions, please contact the OptumInsight Support team by opening a ticket online or by calling 877-309-4256. Please do not respond to this email with questions.

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