UnitedHealthcare Laboratory Test Registration: How to Prepare and Comply

UHC Laboratory Test Code Registry – Delayed

UPDATE (7/1/2021) – UnitedHealthcare is delaying the implementation of the clinical and pathology Laboratory Test Registry Protocol until further notice. This includes registration of non-genetic tests and placement of test codes on claims for non-genetic tests. There is no need to register non-genetic tests at this time.

Laboratory Test Registry Protocol

Effective January 1, 2022, UnitedHealthcare (UHC) will require in-network, freestanding, and outpatient hospital laboratories to include the laboratory’s unique test code on claims for most laboratory test services. Each test code submitted on a claim must match a corresponding laboratory test registration provided in advance to UHC, or the claim will be denied.

Meet Compliance Requirements with Quadax

Registration Determination

To ensure compliance, laboratory providers subject to these requirements must self-register their tests prior to December 1, 2021. These requirements apply to most UHC Commercial, Medicare Advantage and UHC Community Plan networks. As defined by UHC, a laboratory test code is the lab’s unique identifier used by a physician to order a test. UHC is not specifying which values or coding method to use to uniquely identify tests. Labs are free to use their own test codes as long as the codes are in the UHC registry.

We have outlined the UHC strategies for test registration in the white paper Quadax UHC Laboratory Test Registration: How to Prepare and Comply, which can assist clients with each step of the registration determination process, including sending test codes to Quadax and lab code claim criteria details.

All in-network freestanding (Place of Service 81) and outpatient (Place of Service 19 or 22, Revenue Codes 300-319 and 971) hospital laboratory testing services are included in test registration.

Genetic and molecular test services subject to UHC special process or the National Institutes of Health (NIH) registration policy are excluded from registration, as are test services rendered by outpatient physician office laboratories (i.e. those billing Place of Service 11) and test services for which UHC is not the primary payer.

Quadax Resources

Quadax created informational tools to assist our lab clients with learning what steps they need to take to comply with the UHC Lab Test Code Registry requirement. A comprehensive white paper provides an overview of the protocol as well as decision trees and a check list to help your lab determine the actions they need to take now.

Quadax UHC Laboratory Test Registration: How to Prepare and Comply – White Paper (PDF)
Quadax UHC Lab Code Claim Criteria Tree (PDF)
Quadax UHC Lab Test Registration Decision Tree (PDF)
Quadax UHC Lab Test Registration Required Actions Checklist (PDF)

UHC Resources

UnitedHealthcare Laboratory Test Registry Protocol
UnitedHealthcare Laboratory Test Registry Protocol FAQs
UnitedHealthcare Laboratory Test Registry Tool FAQs