CurrentColorado Rocky Mountain Health PlansPolicy N/A

Reimbursement policy: homocysteine testing (procedure code 83090)

Defines UnitedHealthcare Community Plan's reimbursement methodology for homocysteine testing (procedure code 83090) for Medicaid products and the providers who bill UB-04/CMS-1500 forms.

Policy Summary

PayerColorado Rocky Mountain Health Plans

PolicyReimbursement policy: homocysteine testing

Policy CodePolicy N/A

Change TypeNo material changes

Effective DateN/A

Next Review DateApr 1, 2026

Key ActionSubmit accurate claims using CMS-1500 or UB-04 forms or electronic equivalents; reimbursement considered when code 83090 is used for listed conditions.

SourceLink

POLICY UPDATE CHANGES

No material clinical or coverage changes in this revision.

1procedure code listed (83090)

3covered clinical indications listed

15states listed as exempt from this policy

2document history dates shown

Coverage Criteria for Homocysteine Testing (CPT 83090)

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Coverage criteria for CPT 83090

UnitedHealthcare will consider reimbursement of homocysteine testing (procedure code 83090) when billed for the following conditions:

Covered when billed with CPT code 83090 (Homocysteine; quantitative).

ONE of

Homocystinuria — inherited disorder of methionine metabolism; testing considered for this condition.
Vitamin B12 deficiency — testing considered when deficiency is present or suspected.
Chronic ischemic heart disease — testing considered when associated with chronic ischemic heart disease.

Exclusion: UnitedHealthcare will not consider reimbursement of homocysteine testing (CPT 83090) for conditions other than those listed above.

Claims Submission and Billing Instructions

Billing Rule

Claims submission and applicable form

Submit accurate claims on the CMS-1500 or UB-04 (and their electronic equivalents) so reimbursement is based on the code(s) that correctly describe the services provided; reimbursement will be considered when procedure code 83090 is used for the listed conditions.

Use CMS-1500 or UB-04 forms (or electronic equivalents) for reporting services.
Ensure claims are accurate and report procedure code 83090 (Homocysteine; quantitative) when billing for the covered indications.

Reimbursement Policy Definitions

Reimbursement policy

DefinitionReimbursement policy: guidance to ensure reimbursement based on codes that correctly describe the health care services provided; uses CPT, CMS, or other coding guidelines for definitional purposes.

ScopeApplies to services billed on CMS-1500 forms and, when specified, to those billed on UB-04 forms for UnitedHealthcare Community Plan Medicaid products.

Provider responsibilityYou are responsible for submission of accurate claims to ensure reimbursement reflects the codes that describe services provided.

Use of coding referencesReferences to CPT or other sources are for definitional purposes only and do not imply any right to reimbursement.

Policy discretionUnitedHealthcare Community Plan may use reasonable discretion in interpreting and applying this policy and may modify the policy by publishing a new version.