Beginning September 1, 2026, telehealth claims billed with Place of Service (POS) 02 or POS 10 will be subject to the same ICD-10-CM Excludes1 editing rules currently applied to other claim types. This update extends existing ICD-10-CM coding standards to telehealth claims to support consistent claims processing. Claims submitted with diagnosis code combinations prohibited by an Excludes1 note may not be eligible for reimbursement. Member benefits and telehealth coverage remain unchanged by this update.

To support accurate claims processing, care providers should:

• Review ICD-10-CM Excludes1 notes before submitting telehealth claims.
• Verify that diagnosis codes reported together are not prohibited by an Excludes1 convention.
• Code to the highest level of specificity and ensure documentation supports the selected diagnosis.

Excludes1 notes and telehealth claims

Excludes1 notes identify diagnosis code combinations that should not be reported together. As you document and code telehealth services, review Excludes1 notes before submitting claims. For example, Z01.419 (gynecological examination without abnormal findings) and Z12.4 (screening for malignant neoplasm of the cervix) may not be reported together because of an Excludes1 note. Care providers should select diagnosis codes that accurately reflect the services performed and the supporting documentation.

Questions or disputes

If you believe an Excludes1-related claim outcome does not align with ICD-10-CM coding guidance, verify the guidance in the current ICD-10-CM code set and submit a dispute through the standard process. Most disputes can be submitted electronically via https://Availity.com or in writing using the Provider Dispute Resolution Form. Include relevant claim details and supporting documentation for review and use the Availity Appeals Dashboard to upload materials and track the status. For questions about this update, please contact your provider relationship management representative.

Every year, the New York State Department of Health requires health care professionals to complete cultural competency training. Health care professionals can take one of the state’s free accredited online courses in the Think Cultural Healthopen_in_new training guide.

These training courses give you an overview of cultural, health literacy and language needs for diverse populations. By understanding these needs, you can build a relationship of trust and help enhance patients’ overall health outcomes.

How to take the required training

There are 2 ways to access the Think Cultural Health training: through the UnitedHealthcare Provider Portal or the U.S. Department of Health & Human Services. Going through the UnitedHealthcare Provider Portal simplifies the attestation process and tracks that you’ve fulfilled your requirement.

UnitedHealthcare Provider Portal

• Sign in to the UnitedHealthcare Provider Portal and enter your One Healthcare ID
• If you don’t have a One Healthcare ID, register now
• Go to the Tailored Training page under Profile & Settings
  • On the Required Training tab, click on the course titled U.S. Department of Health and Human Services — Think Cultural Health. This will bring you to the guideopen_in_new where you can log in or register to take the training that best corresponds to your specialty.
  • You may notice a disclaimer at the beginning of each of the courses, stating that we’re working on posting an updated version of the courses. Until the updated versions are posted, the current courses are still valid and available for you to take to meet the requirement.

Once you complete the training, return to the Tailored Training page

• Click the link under the Provider Status heading
• Click on the applicable provider name(s) and choose “Mark as Completed” under Bulk Options. This will automatically provide evidence that you’ve completed the course.

U.S. Department of Health & Human Services

• If you don’t have access to the Provider Portal, go directly to the guideopen_in_new and complete the following steps:
  • Log in and choose the program that corresponds with your scope of practice

Once you complete the training, download the roster, fill out the requested information and email it to our Cultural Competency team. Use the subject line: Think Cultural Health training.