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UnitedHealthcareMedicaid · Billing Codes · Medical Benefit Drug Policy · TN · Allergy & Immunology, Internal Medicine, PharmacyMedium impact

Hereditary Angioedema (HAE), Treatment and Prophylaxis

Effective date
Nov 1, 2026
Identified
Nov 7, 2026

Summary

UnitedHealthcare Community Plan of Tennessee updated its Hereditary Angioedema (HAE) treatment and prophylaxis medical benefit drug policy in its November 2026 bulletin, with the status listed as updated and an effective date of 2026-11-01. The update revises the list of applicable CPT codes to reflect quarterly edits and adds codes 0678U and 0679U. Billing teams should review HAE-related charges for these Tennessee Medicaid members and update charge entry so claims carry the codes the policy now lists.

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What to do

Action · 4 steps
01Already effective 2026-11-01: Billing team should pull the current HAE treatment and prophylaxis policy from the UnitedHealthcare Community Plan of Tennessee bulletin and compare its applicable CPT code list against the codes currently loaded in charge entry for Tennessee Medicaid members.
02Add 0678U and 0679U to the HAE code set in charge entry and claim edit lists where HAE services are billed, and remove any codes the updated list no longer includes.
03Providers and front desk staff should be told that HAE-related services for these members should be documented and coded against the updated list.
04Watch for the payer's next bulletin for any further quarterly code edits.

Original notice

Hereditary Angioedema (HAE), Treatment and Prophylaxis
uhcprovider.com · Always check the source before changing claims.
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