Outpatient Procedure Grouper Mapping Update

On Jan. 1, 2021, the following code updates will be made to the current plan 2020 UnitedHealthcare Outpatient Procedure Grouper (OPG) mapping:

Expired codes

  • 13 OPG 0-10 codes expire on Dec. 31, 2020
  • The codes will be deleted from the UnitedHealthcare OPG Exhibit on Jan. 1, 2021
  • An additional 8 OPG unlisted codes expire and will be deleted as well

Newly published codes

  • 17 OPG 0-10 codes will be added to the UnitedHealthcare OPG Exhibit on Jan. 1, 2021
  • An additional 22 OPG unlisted codes will be added as well

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

For reimbursement under the OPG, we require the appropriate line level CPT®/Healthcare Common Procedure Coding System (HCPCS) code, in addition to the revenue code, when billing for outpatient procedures.

Our updated 2020 UnitedHealthcare OPG Exhibit is available at UHCprovider.com/claims under View UnitedHealthcare Outpatient Procedure Grouper (OPG) Exhibits.

CPT® is a registered trademark of the American Medical Association.