Maryland Medicaid: Updated list of emergency room diagnosis not requiring review

Last modified: Sept. 28, 2023
Revised to include the updated document name

Changes impact UnitedHealthcare Community Plan of Maryland members

UnitedHealthcare recently performed an analysis of our emergency department claims review process and expanded our list of emergency room diagnoses that do not require review. The updated list is effective for claims with dates of service beginning Dec. 1, 2022.

Claims for emergency services with primary ICD-10-CM diagnosis codes on the updated list will be paid for covered members without further documentation.

View the full list for additional details.

Questions?

For more information, view the reimbursement policies for Community Plan of Maryland.

PCA-1-23-03288-POE-UNK_09282023