Humana prior authorization, page 11

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
93312	Transesophageal echocardiogram (TEE)	Medicare Advantage and Dual Eligible Special Needs Plans Prior Authorization and Notification List, Pg 15 Original policy
93313	Transesophageal echocardiogram (TEE)	Medicare Advantage and Dual Eligible Special Needs Plans Prior Authorization and Notification List, Pg 15 Original policy
93314	Transesophageal echocardiogram (TEE)	Medicare Advantage and Dual Eligible Special Needs Plans Prior Authorization and Notification List, Pg 15 Original policy
93315	Transesophageal echocardiogram (TEE)	Medicare Advantage and Dual Eligible Special Needs Plans Prior Authorization and Notification List, Pg 15 Original policy
93316	Transesophageal echocardiogram (TEE)	Medicare Advantage and Dual Eligible Special Needs Plans Prior Authorization and Notification List, Pg 15 Original policy
93317	Transesophageal echocardiogram (TEE)	Medicare Advantage and Dual Eligible Special Needs Plans Prior Authorization and Notification List, Pg 15 Original policy
93318	Transesophageal echocardiogram (TEE)	Medicare Advantage and Dual Eligible Special Needs Plans Prior Authorization and Notification List, Pg 15 Original policy
93355	Transesophageal echocardiogram (TEE)	Medicare Advantage and Dual Eligible Special Needs Plans Prior Authorization and Notification List, Pg 15 Original policy
C8925	Transesophageal echocardiogram (TEE)	Medicare Advantage and Dual Eligible Special Needs Plans Prior Authorization and Notification List, Pg 15 Original policy
C8926	Transesophageal echocardiogram (TEE)	Medicare Advantage and Dual Eligible Special Needs Plans Prior Authorization and Notification List, Pg 15 Original policy
C8927	Transesophageal echocardiogram (TEE)	Medicare Advantage and Dual Eligible Special Needs Plans Prior Authorization and Notification List, Pg 15 Original policy
E0469	Airway Clearance Devices	Medicare Advantage and Dual Eligible Special Needs Plans Prior Authorization and Notification List, Pg 15 Original policy
E0481	Airway Clearance Devices	Medicare Advantage and Dual Eligible Special Needs Plans Prior Authorization and Notification List, Pg 15 Original policy
E0482	Airway Clearance Devices	Medicare Advantage and Dual Eligible Special Needs Plans Prior Authorization and Notification List, Pg 15 Original policy
E2508	Augmentative and Alternative Communication Devices – Notification	Medicare Advantage and Dual Eligible Special Needs Plans Prior Authorization and Notification List, Pg 15 Original policy
E2510	Augmentative and Alternative Communication Devices – Notification	Medicare Advantage and Dual Eligible Special Needs Plans Prior Authorization and Notification List, Pg 15 Original policy
E2599	Augmentative and Alternative Communication Devices – Notification	Medicare Advantage and Dual Eligible Special Needs Plans Prior Authorization and Notification List, Pg 15 Original policy
E3000	Augmentative and Alternative Communication Devices	Medicare Advantage and Dual Eligible Special Needs Plans Prior Authorization and Notification List, Pg 15 Original policy
A4238	Diabetic Treatment and	Medicare Advantage and Dual Eligible Special Needs Plans Prior Authorization and Notification List, Pg 15 Original policy
A4239	Diabetic Treatment and	Medicare Advantage and Dual Eligible Special Needs Plans Prior Authorization and Notification List, Pg 15 Original policy
A9274	Diabetic Treatment and	Medicare Advantage and Dual Eligible Special Needs Plans Prior Authorization and Notification List, Pg 15 Original policy
E0784	Supplies	Medicare Advantage and Dual Eligible Special Needs Plans Prior Authorization and Notification List, Pg 15 Original policy
E2102	Supplies	Medicare Advantage and Dual Eligible Special Needs Plans Prior Authorization and Notification List, Pg 15 Original policy
E2103	Supplies	Medicare Advantage and Dual Eligible Special Needs Plans Prior Authorization and Notification List, Pg 15 Original policy
E0762	Electrical Stimulators	Medicare Advantage and Dual Eligible Special Needs Plans Prior Authorization and Notification List, Pg 15 Original policy
E0766	Electrical Stimulators	Medicare Advantage and Dual Eligible Special Needs Plans Prior Authorization and Notification List, Pg 15 Original policy
E0486	Obstructive Sleep Apnea	Medicare Advantage and Dual Eligible Special Needs Plans Prior Authorization and Notification List, Pg 15 Original policy
E0490	Obstructive Sleep Apnea	Medicare Advantage and Dual Eligible Special Needs Plans Prior Authorization and Notification List, Pg 15 Original policy
E0491	Obstructive Sleep Apnea	Medicare Advantage and Dual Eligible Special Needs Plans Prior Authorization and Notification List, Pg 15 Original policy
E0492	Non-Surgical Treatments	Medicare Advantage and Dual Eligible Special Needs Plans Prior Authorization and Notification List, Pg 15 Original policy
E0493	Non-Surgical Treatments	Medicare Advantage and Dual Eligible Special Needs Plans Prior Authorization and Notification List, Pg 15 Original policy
K1027	Non-Surgical Treatments	Medicare Advantage and Dual Eligible Special Needs Plans Prior Authorization and Notification List, Pg 15 Original policy
E0650	Pneumatic Compression	Medicare Advantage and Dual Eligible Special Needs Plans Prior Authorization and Notification List, Pg 15 Original policy
E0651	Pneumatic Compression	Medicare Advantage and Dual Eligible Special Needs Plans Prior Authorization and Notification List, Pg 15 Original policy
E0652	Pneumatic Compression	Medicare Advantage and Dual Eligible Special Needs Plans Prior Authorization and Notification List, Pg 15 Original policy
E0658	Pneumatic Compression	Medicare Advantage and Dual Eligible Special Needs Plans Prior Authorization and Notification List, Pg 15 Original policy
E0659	Pneumatic Compression	Medicare Advantage and Dual Eligible Special Needs Plans Prior Authorization and Notification List, Pg 15 Original policy
E0660	Pneumatic Compression	Medicare Advantage and Dual Eligible Special Needs Plans Prior Authorization and Notification List, Pg 15 Original policy
E0665	Pneumatic Compression	Medicare Advantage and Dual Eligible Special Needs Plans Prior Authorization and Notification List, Pg 15 Original policy
E0666	Pneumatic Compression	Medicare Advantage and Dual Eligible Special Needs Plans Prior Authorization and Notification List, Pg 15 Original policy
E0667	Pneumatic Compression	Medicare Advantage and Dual Eligible Special Needs Plans Prior Authorization and Notification List, Pg 15 Original policy
E0668	Pneumatic Compression	Medicare Advantage and Dual Eligible Special Needs Plans Prior Authorization and Notification List, Pg 15 Original policy
E0669	Pneumatic Compression	Medicare Advantage and Dual Eligible Special Needs Plans Prior Authorization and Notification List, Pg 15 Original policy
E0670	Pneumatic Compression	Medicare Advantage and Dual Eligible Special Needs Plans Prior Authorization and Notification List, Pg 15 Original policy
E0671	Pneumatic Compression	Medicare Advantage and Dual Eligible Special Needs Plans Prior Authorization and Notification List, Pg 15 Original policy
E0672	Pneumatic Compression	Medicare Advantage and Dual Eligible Special Needs Plans Prior Authorization and Notification List, Pg 15 Original policy
E0673	Pneumatic Compression	Medicare Advantage and Dual Eligible Special Needs Plans Prior Authorization and Notification List, Pg 15 Original policy
K0900	Unlisted DME	Medicare Advantage and Dual Eligible Special Needs Plans Prior Authorization and Notification List, Pg 16 Original policy
E0691	UV Light Therapy	Medicare Advantage and Dual Eligible Special Needs Plans Prior Authorization and Notification List, Pg 16 Original policy
E0692	UV Light Therapy	Medicare Advantage and Dual Eligible Special Needs Plans Prior Authorization and Notification List, Pg 16 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.