On July 20, 2023, United Healthcare (UHC) announced they will begin enforcing Z-Code requirements starting October 1, 2023, rather than its initial date of August 1. Because of the amount of time it takes to complete the registration process for Phase 1 CPT® codes, UHC is recommending labs to begin the process as soon as possible.
Labs not currently registered with the DEX® Registry and who plan to submit molecular diagnostic claims are urged to sign up immediately (www.dexzcodes.com). A limited number of CPT codes will be part of Phase 1. There will be additional phases until the codes within scope are completed.
Labs billing with one of the CPT codes on this list or perform services listed below, a Z-Code will need to be registered in the DEX Registry.
Services requiring Z-Codes:
- All adult molecular diagnostic tests relevant to the Medicare age population (65+)
- Prenatal Carrier Screening tests
- Specific services billed under 81479*
- Genetic disease carrier status for procreative management
- Pharmacogenomics testing (PGx) including single gene and multi-gene panel
Submitting the test(s) before the deadline allows time to identify and fix possible errors or omissions with test submissions. For further information, refer to DEX Diagnostics Exchange Test Registration.
Source(s):
https://www.dexzcodes.com/palmetto/dex.nsf/DID/5PQ2G7SR9K
https://www.uhcprovider.com/en/resource-library/news/2023/expanded-dex-z-codes-molecular-tests.html