UnitedHealthcare Expands Multiple Genetic and Molecular Policies

UnitedHealthcare (UHC) Community Plan’s August policy update revised several medical policies to reflect phase 2 of the DEX® Z-Code requirement for certain molecular diagnostic test services on facility and professional claims.

A DEX® Z-Code is a unique identifier that indicates the test being performed on a claim and allows payers to know exactly what service was rendered. The UHC policy will require the submission of a Z-Code obtained from the DEX® Diagnostics Exchange Registry for claims to be considered for reimbursement.

Included in phase 2 of this policy are venous thromboembolism risk and hereditary thrombophilia testing; diagnosis and high-risk inherited cancer panel; and new Current Procedural Terminology (CPT) and Proprietary Laboratory Analyses (PLA) codes relevant to the scope of services announced.

New PLA codes include 0648U, 0650U, 0651U, 0652U, and several sequencing codes. A complete list of affected medical policies and their applicable code changes is available on the UHC website.

These updates were effective Aug. 1, 2026.

Sources:

https://www.uhcprovider.com/content/dam/provider/docs/public/policies/medicaid-comm-plan/community-plan-medical-policy-update-bulletin-august-2026.pdf

https://dominoapps.palmettogba.com/palmetto/providers.nsf/files/Commercial_and_Medicaid_CPT_Codes.pdf/$FILE/Commercial_and_Medicaid_CPT_Codes.pdf

https://www.dexzcodes.com/dex/did/i9szsoroou?cat=dex-commercial-plans

https://www.dexzcodes.com/dex/did/t7suingo3s?cat=dex-commercial-plans

https://www.uhcprovider.com/content/dam/provider/docs/public/policies/mpub-archives/comm-plan/community-plan-medical-policy-update-bulletin-august-2026-full.pdf