Humana prior authorization, page 10

Requirements

Notification and authorization stay separate. An approved notification row keeps the notification label. The long descriptor is blank because no AMA-licensed CPT file was available to copy.

CPT code lookup

Prior authorization codes

Prior authorization codes
Code	Description	Source
C8905	Magnetic resonance imaging (MRI)	Medicare Advantage and Dual Eligible Special Needs Plans Prior Authorization and Notification List, Pg 14 Original policy
C8906	Magnetic resonance imaging (MRI)	Medicare Advantage and Dual Eligible Special Needs Plans Prior Authorization and Notification List, Pg 14 Original policy
C8908	Magnetic resonance imaging (MRI)	Medicare Advantage and Dual Eligible Special Needs Plans Prior Authorization and Notification List, Pg 14 Original policy
C9762	Magnetic resonance imaging (MRI)	Medicare Advantage and Dual Eligible Special Needs Plans Prior Authorization and Notification List, Pg 14 Original policy
C9763	Magnetic resonance imaging (MRI)	Medicare Advantage and Dual Eligible Special Needs Plans Prior Authorization and Notification List, Pg 14 Original policy
C9791	Magnetic resonance imaging (MRI)	Medicare Advantage and Dual Eligible Special Needs Plans Prior Authorization and Notification List, Pg 14 Original policy
78451	Myocardial perfusion imaging single photon emission computed tomography (MPI-SPECT)	Medicare Advantage and Dual Eligible Special Needs Plans Prior Authorization and Notification List, Pg 14 Original policy
78452	Myocardial perfusion imaging single photon emission computed tomography (MPI-SPECT)	Medicare Advantage and Dual Eligible Special Needs Plans Prior Authorization and Notification List, Pg 14 Original policy
A9611	Myocardial perfusion imaging single photon emission computed tomography (MPI-SPECT)	Medicare Advantage and Dual Eligible Special Needs Plans Prior Authorization and Notification List, Pg 14 Original policy
78453	Nuclear stress test	Medicare Advantage and Dual Eligible Special Needs Plans Prior Authorization and Notification List, Pg 14 Original policy
78454	Nuclear stress test	Medicare Advantage and Dual Eligible Special Needs Plans Prior Authorization and Notification List, Pg 14 Original policy
78466	Nuclear stress test	Medicare Advantage and Dual Eligible Special Needs Plans Prior Authorization and Notification List, Pg 14 Original policy
78468	Nuclear stress test	Medicare Advantage and Dual Eligible Special Needs Plans Prior Authorization and Notification List, Pg 14 Original policy
78469	Nuclear stress test	Medicare Advantage and Dual Eligible Special Needs Plans Prior Authorization and Notification List, Pg 14 Original policy
78472	Nuclear stress test	Medicare Advantage and Dual Eligible Special Needs Plans Prior Authorization and Notification List, Pg 14 Original policy
78473	Nuclear stress test	Medicare Advantage and Dual Eligible Special Needs Plans Prior Authorization and Notification List, Pg 14 Original policy
78481	Nuclear stress test	Medicare Advantage and Dual Eligible Special Needs Plans Prior Authorization and Notification List, Pg 14 Original policy
78483	Nuclear stress test	Medicare Advantage and Dual Eligible Special Needs Plans Prior Authorization and Notification List, Pg 14 Original policy
93350	Nuclear stress test	Medicare Advantage and Dual Eligible Special Needs Plans Prior Authorization and Notification List, Pg 14 Original policy
93351	Nuclear stress test	Medicare Advantage and Dual Eligible Special Needs Plans Prior Authorization and Notification List, Pg 14 Original policy
C8928	Nuclear stress test	Medicare Advantage and Dual Eligible Special Needs Plans Prior Authorization and Notification List, Pg 14 Original policy
C8930	Nuclear stress test	Medicare Advantage and Dual Eligible Special Needs Plans Prior Authorization and Notification List, Pg 14 Original policy
36245	Peripheral angiography	Medicare Advantage and Dual Eligible Special Needs Plans Prior Authorization and Notification List, Pg 14 Original policy
36246	Peripheral angiography	Medicare Advantage and Dual Eligible Special Needs Plans Prior Authorization and Notification List, Pg 14 Original policy
36247	Peripheral angiography	Medicare Advantage and Dual Eligible Special Needs Plans Prior Authorization and Notification List, Pg 14 Original policy
78429	Positron emission tomography (PET) scan/National Oncology	Medicare Advantage and Dual Eligible Special Needs Plans Prior Authorization and Notification List, Pg 14 Original policy
78430	Positron emission tomography (PET) scan/National Oncology	Medicare Advantage and Dual Eligible Special Needs Plans Prior Authorization and Notification List, Pg 14 Original policy
78431	Positron emission tomography (PET) scan/National Oncology	Medicare Advantage and Dual Eligible Special Needs Plans Prior Authorization and Notification List, Pg 14 Original policy
78432	Positron emission tomography (PET) scan/National Oncology	Medicare Advantage and Dual Eligible Special Needs Plans Prior Authorization and Notification List, Pg 14 Original policy
78433	Positron emission tomography (PET) scan/National Oncology	Medicare Advantage and Dual Eligible Special Needs Plans Prior Authorization and Notification List, Pg 14 Original policy
78459	Positron emission tomography (PET) scan/National Oncology	Medicare Advantage and Dual Eligible Special Needs Plans Prior Authorization and Notification List, Pg 14 Original policy
78491	Positron emission tomography (PET) scan/National Oncology	Medicare Advantage and Dual Eligible Special Needs Plans Prior Authorization and Notification List, Pg 14 Original policy
78492	Positron emission tomography (PET) scan/National Oncology	Medicare Advantage and Dual Eligible Special Needs Plans Prior Authorization and Notification List, Pg 14 Original policy
78608	Positron emission tomography (PET) scan/National Oncology	Medicare Advantage and Dual Eligible Special Needs Plans Prior Authorization and Notification List, Pg 14 Original policy
78811	PET Registry (NOPR)	Medicare Advantage and Dual Eligible Special Needs Plans Prior Authorization and Notification List, Pg 14 Original policy
78812	PET Registry (NOPR)	Medicare Advantage and Dual Eligible Special Needs Plans Prior Authorization and Notification List, Pg 14 Original policy
78813	PET Registry (NOPR)	Medicare Advantage and Dual Eligible Special Needs Plans Prior Authorization and Notification List, Pg 14 Original policy
78814	PET Registry (NOPR)	Medicare Advantage and Dual Eligible Special Needs Plans Prior Authorization and Notification List, Pg 14 Original policy
78815	PET Registry (NOPR)	Medicare Advantage and Dual Eligible Special Needs Plans Prior Authorization and Notification List, Pg 14 Original policy
78816	PET Registry (NOPR)	Medicare Advantage and Dual Eligible Special Needs Plans Prior Authorization and Notification List, Pg 14 Original policy
A9587	Prostate-specific membrane antigen (PSMA/PET CT)	Medicare Advantage and Dual Eligible Special Needs Plans Prior Authorization and Notification List, Pg 15 Original policy
A9593	Prostate-specific membrane antigen (PSMA/PET CT)	Medicare Advantage and Dual Eligible Special Needs Plans Prior Authorization and Notification List, Pg 15 Original policy
A9594	Prostate-specific membrane antigen (PSMA/PET CT)	Medicare Advantage and Dual Eligible Special Needs Plans Prior Authorization and Notification List, Pg 15 Original policy
A9595	Prostate-specific membrane antigen (PSMA/PET CT)	Medicare Advantage and Dual Eligible Special Needs Plans Prior Authorization and Notification List, Pg 15 Original policy
A9596	Prostate-specific membrane antigen (PSMA/PET CT)	Medicare Advantage and Dual Eligible Special Needs Plans Prior Authorization and Notification List, Pg 15 Original policy
A9597	Prostate-specific membrane antigen (PSMA/PET CT)	Medicare Advantage and Dual Eligible Special Needs Plans Prior Authorization and Notification List, Pg 15 Original policy
A9608	Prostate-specific membrane antigen (PSMA/PET CT)	Medicare Advantage and Dual Eligible Special Needs Plans Prior Authorization and Notification List, Pg 15 Original policy
A9616	Prostate-specific membrane antigen (PSMA/PET CT)	Medicare Advantage and Dual Eligible Special Needs Plans Prior Authorization and Notification List, Pg 15 Original policy
A9800	Prostate-specific membrane antigen (PSMA/PET CT)	Medicare Advantage and Dual Eligible Special Needs Plans Prior Authorization and Notification List, Pg 15 Original policy
78494	Single-photon emission computerized tomography (SPECT) scan	Medicare Advantage and Dual Eligible Special Needs Plans Prior Authorization and Notification List, Pg 15 Original policy

Medicare

The rows above are limited to the Medicare Advantage scopes in each table. They are not a single Medicare answer. Each row shows its own reviewed disposition.

Precertification list

Humana Medicare Advantage and D-SNP prior authorization and notification list

Humana prior authorization lists

Humana prior authorization search tool

Sources

Disclaimer

The information provided on this page is for general informational purposes only and does not constitute billing, coding, or reimbursement advice. Nothing on this page should be relied upon as a substitute for clinician assessment, professional billing guidance, or as a definitive statement of any payor's billing requirements or policies.

Payor agreements, fee schedules, and billing policies vary and are subject to change. Before submitting any claims related to maternity care services, including claims affected by the 2027 CPT code revisions, please consult the applicable payor agreements, coverage policies, and billing guidelines to confirm current requirements for their specific payor contracts.

Substrate makes no representation or warranty regarding the accuracy, completeness, or timeliness of the payor-specific information presented here. Providers are solely responsible for ensuring that all claims are submitted in accordance with applicable payor requirements, and Substrate assumes no liability for claim denials, underpayments, or other adverse outcomes arising from reliance on this information.