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Industry Insights

UHC Medicare Advantage claims to require DEX Z-code beginning Oct. 1
By: AJ Lech, Client Administrator, Lighthouse Lab Services The UnitedHealthcare Medicare Advantage product will now require a DEX Z-code, effective 10/1/21. Similar to Medicare, the Z-code will be submitted in the Loop 2400. UHC will not require any separate registration for the qualifying codes. However, you should be sure to double-check the qualifying tests to ensure they are registered on MolDX. Tests not already registered with a DEX Z test code can be registered via the MolDX Program, which is administered by Palmetto GBA. To receive a DEX Z-Code identifier, visit the DEXTM Diagnostics Exchange, choose “Register My Organization” and follow the prompts, including participation in the MolDX program. When asked if this would extend to all MACs or just those that utilize MolDX, a Palmetto rep informed us, “UHC will roll out the Z-code requirement to their Medicare Advantage plans in MolDx jurisdictions with the plan to expand to all states at a future date to be determined.”
Current MolDX MAC jurisdictions  
The four current MolDX jurisdictions
Given this news, now would be a great time to review your test compendium and payer mix. Are there any qualifying tests that need to be registered on the MolDX? It’s likely only a matter of time before UHC will roll this requirement out to other products, so now is the time to plan your next steps. Contact us today for a free consultation.

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