We continue to ensure that all documents are updated for ICD-10 Terminology. Providers should be aware that ICD-9 content applies to dates of service prior to 10/1/2015. ICD-10 terminology and claims sets apply to dates of service 10/1/2015 and after, regardless of the status of the document.
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HIPAA Claim Edits
UnitedHealthcare applies HIPAA edits to professional (837p) and Institutional (837i) claims submitted electronically. Visit the EDI Claim Edits page for more information including a complete list of edits, edits related to ICD-10 codes and applicable payers. Claims that reject for HIPAA edits will appear on a clearinghouse level report, enabling you to Identify and correct rejected Information prior to UnitedHealthcare receiving the claim.
UnitedHealth Group requires compliance with the requirements of federal and state laws that prohibit the submission of false claims in connection with federal health care programs, including Medicare and Medicaid. Click here (PDF 38.15 KB) to download our policy.