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UHC – Medicare Advantage Reimbursement Policy Update Bulletin

August 5, 2022

Molecular Pathology Policy Professional and Facility – 10/01/2022

The policy has been updated to provide further details of payment policies associated with molecular pathology claims: • Reimbursement Guidelines section revised to include guidelines for Multiple Gene Testing with code table references for Tier 1 and Tier 2 Molecular Pathology codes, Genomic Sequencing Procedures and Other Molecular Multianalyte Assays.

• Definitions section revised to include definitions for Genomic Sequencing Procedures and Other Molecular Multianalyte Assays and Proprietary Laboratory Analysis (PLA) Codes.

• Questions and Answers (Q&A) section updated to include additional Q&A specific to Multiple Gene Testing

Source: https://www.uhcprovider.com/content/dam/provider/docs/public/policies/medadv-reimbursement/rpub/UHC-MEDADV-RPUB-JUL-2022.pdf

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