Outpatient Procedure Grouper mapping update

On Jan. 1, 2023, we made the following updates to the current plan 2022 UnitedHealthcare Outpatient Procedure Grouper mapping:

Expired codes

• A total of 32 Outpatient Procedure Grouper 0-10 codes expired on Dec. 31, 2022
• We deleted these codes from the UnitedHealthcare Outpatient Procedure Grouper Exhibit on Jan. 1, 2023
• An additional 2 Outpatient Procedure Grouper unlisted codes expired and were deleted

Newly published codes

• We added 31 Outpatient Procedure Grouper 0-10 codes to the UnitedHealthcare Outpatient Procedure Grouper Exhibit on Jan. 1, 2023
• We added an additional 79 Outpatient Procedure Grouper unlisted codes

There are no other grouper level assignment changes to existing codes.

For reimbursement under the Outpatient Procedure Grouper, we require the appropriate line level CPT®/HCPCS code, in addition to the revenue code, when billing for outpatient procedures.

Questions?

For more information, view the updated 2022 UnitedHealthcare OPG Exhibit.

CPT® is a registered trademark of the American Medical Association

PCA-1-22-04326-UHN-News_01032022