UnitedHealthcare has announced three major policy changes taking effect in early 2026 that will directly impact claim submission, documentation, and reimbursement for medical practices.

In this KZA Alert, we break down:

• New mandatory anatomical modifier requirements for surgical and radiology claims
• Enforcement of ICD-10-CM Excludes1 coding rules across outpatient and professional services
• Updated radiology interpretation documentation standards required for professional component reimbursement

This rapid-response update is designed to help practice leaders, coders, billers, and compliance teams understand what’s changing, when it takes effect, and what actions to take now to avoid denials and payment delays.

Links to source documentation (including UnitedHealthcare policy updates, the 2026 ICD-10-CM coding guidelines, and CPT references) are available in the corresponding web version of this alert.

KZA Web Alert: https://www.kzanow.com/alerts/united-healthcare-policy-changes

On November 13th, 2025, the 43-day federal government shutdown officially ended, and Congress has passed a continuing resolution funding the government through January 30, 2026. For medical practices, this brings a critical update: Medicare telehealth flexibilities have been restored, extended, and made retroactively applicable to services delivered during the shutdown period.

In this KZA Alert, we break down what the continuing resolution means for Medicare providers, including:

• Which pandemic-era telehealth flexibilities are back in effect
• How retroactive coverage applies to claims submitted—or held—after October 1, 2025
• What specialty practices need to know about resuming telehealth services
• Immediate action steps for billing, coding, scheduling, and revenue cycle teams
• Why this extension represents temporary relief—not a permanent policy solution

This fast, focused update is designed to help practice leaders, managers, coders, and billers understand what changed, what actions to take now, and how to prepare for the next potential telehealth policy cliff in early 2026.

KZA Web Alert and links to sources: https://www.kzanow.com/alerts/telehealth-extended