![]() In those instances where Grouping of services applies, the number of units submitted should be equally divisible by the number of days indicated in the 'from' and 'to' dates reported. Grouping is allowed only for identical services on consecutive days. Note: for instructions to Content Managers, Word formats are acceptable.For Large Volume Requests Only: If you are requesting an update to more than five documents, please download and fill out the XLS template provided below and attach completed XLS file using the "Add Documents" feature above.Download Large Volume Request XLS Template >WEB Name of Alternate Contact or Content OwnerCathrine GamboaWEB Approval Completed? Provider Communication Review Not RequiredWEB Reason Why Provider Communication Review Not RequiredReimbursement policy, review not required.WEB Requested Posting Time Other Specific DateWEB Detail Reason and Posting Date DesiredAnniversary review needs posting WEB Add New or Update Update or RemoveWEB Document Display Names From - To Date Policy, Professional - Reimbursement Policy - UnitedHealthcare Medicare Advantage PlansWEB Description for When Grouping services, the place of service, procedure code, charges, and individual provider for each line must be identical for that service line. Any other document format must be approved as an exception (.xls. Make sure your document has already been converted into PDF format. To that end, CMS coding principles applicable to emergency department services provide that facility coding guidelines should: follow the intent of the CPT code descriptor in that the guidelines should be designed to reasonably relate the intensity of hospital resources to the different levels of effort represented by the code be based on hospital facility resources and not based on physician resources and not facilitate upcoding or gaming. CMS Coding Principles CMS indicates facilities should bill appropriately and differentially for outpatient visits, including emergency department visits. This policy is based on coding principles established by the Centers for Medicare and Medicaid Services (CMS)1, and the CPT and HCPCS code descriptions. ![]() This policy describes how UnitedHealthcare Value & Balance Exchange reimburses UB claims billed with Evaluation and Management (E/M) codes Level 4 (99284/G0383) and Level 5 (99285/G0384) for services rendered in an emergency department. ![]()
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