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UHC – Preventive Care Services – Commercial Coverage Determination Guideline – CDG.016.43

December 5, 2022

: Effective 1/1/2023 – Revision updates include

Preventive Care Services Hepatitis B Virus Infection Screening

Updated service description; added Jul. 2022 Bright Futures guideline to indicate Bright Futures recommends screening between the ages 0-21 years [perform risk assessment for hepatitis B virus (HBV) infection]

Updated lists of applicable codes;

 added:

o CPT code 87467

o ICD-10 diagnosis codes Z00.121 and Z00.129

Source: https://www.uhcprovider.com/content/dam/provider/docs/public/policies/index/commercial/preventive-care-services-01012023.pdf

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