Transcription of Multiple Procedure Payment Reduction ... - UHCprovider.com
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Multiple Procedure Payment Reduction ... - UHCprovider.com
UnitedHealthcare Medicare Advantage Reimbursement Policy CMS 1500 Policy Number 2022R9021A Proprietary information of UnitedHealthcare Medicare Advantage. Copyright 2022 United HealthCare Services, Inc. Multiple Procedure Payment Reduction (MPPR) for Medical and Surgical Services Policy, Professional IMPORTANT NOTE ABOUT THIS REIMBURSEMENT POLICY This policy is applicable to UnitedHealthcare Medicare Advantage Plans offered by UnitedHealthcare and its affiliates. You are responsible for submission of accurate claims. This reimbursement policy is intended to ensure that you are reimbursed based on the code or codes that correctly describe the health care services provided. UnitedHealthcare Medicare Advantage reimbursement policies use Current Procedural Terminology (CPT *), Centers for Medicare and Medicaid Services (CMS), or other coding guidelines.
• Multiple Procedure Indicator 2 - Standard payment adjustment rules for multiple procedures apply • Multiple Procedure Indicator 3 - Special rules for multiple endoscopic procedures apply if procedure is billed with another endoscopy in the same family (i.e., another endoscopy that has the same base procedure).
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