Humana prior authorization, page 12

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
E0693	UV Light Therapy	Medicare Advantage and Dual Eligible Special Needs Plans Prior Authorization and Notification List, Pg 16 Original policy
E0694	UV Light Therapy	Medicare Advantage and Dual Eligible Special Needs Plans Prior Authorization and Notification List, Pg 16 Original policy
E0193	Hospital beds and accessories	Medicare Advantage and Dual Eligible Special Needs Plans Prior Authorization and Notification List, Pg 16 Original policy
E0194	Hospital beds and accessories	Medicare Advantage and Dual Eligible Special Needs Plans Prior Authorization and Notification List, Pg 16 Original policy
E0265	Hospital beds and accessories	Medicare Advantage and Dual Eligible Special Needs Plans Prior Authorization and Notification List, Pg 16 Original policy
E0266	Hospital beds and accessories	Medicare Advantage and Dual Eligible Special Needs Plans Prior Authorization and Notification List, Pg 16 Original policy
E0277	Hospital beds and accessories	Medicare Advantage and Dual Eligible Special Needs Plans Prior Authorization and Notification List, Pg 16 Original policy
E0296	Hospital beds and accessories	Medicare Advantage and Dual Eligible Special Needs Plans Prior Authorization and Notification List, Pg 16 Original policy
E0297	Hospital beds and accessories	Medicare Advantage and Dual Eligible Special Needs Plans Prior Authorization and Notification List, Pg 16 Original policy
E0301	Hospital beds and accessories	Medicare Advantage and Dual Eligible Special Needs Plans Prior Authorization and Notification List, Pg 16 Original policy
E0302	Hospital beds and accessories	Medicare Advantage and Dual Eligible Special Needs Plans Prior Authorization and Notification List, Pg 16 Original policy
E0303	Hospital beds and accessories	Medicare Advantage and Dual Eligible Special Needs Plans Prior Authorization and Notification List, Pg 16 Original policy
E0304	Hospital beds and accessories	Medicare Advantage and Dual Eligible Special Needs Plans Prior Authorization and Notification List, Pg 16 Original policy
31647	Emerging technology/new indications for existing technology	Medicare Advantage and Dual Eligible Special Needs Plans Prior Authorization and Notification List, Pg 16 Original policy
31648	Emerging technology/new indications for existing technology	Medicare Advantage and Dual Eligible Special Needs Plans Prior Authorization and Notification List, Pg 16 Original policy
31649	Emerging technology/new indications for existing technology	Medicare Advantage and Dual Eligible Special Needs Plans Prior Authorization and Notification List, Pg 16 Original policy
31651	Emerging technology/new indications for existing technology	Medicare Advantage and Dual Eligible Special Needs Plans Prior Authorization and Notification List, Pg 16 Original policy
43284	Emerging technology/new indications for existing technology	Medicare Advantage and Dual Eligible Special Needs Plans Prior Authorization and Notification List, Pg 16 Original policy
53865	Emerging technology/new indications for existing technology	Medicare Advantage and Dual Eligible Special Needs Plans Prior Authorization and Notification List, Pg 16 Original policy
53866	Emerging technology/new indications for existing technology	Medicare Advantage and Dual Eligible Special Needs Plans Prior Authorization and Notification List, Pg 16 Original policy
0338T	Emerging technology/new indications for existing technology	Medicare Advantage and Dual Eligible Special Needs Plans Prior Authorization and Notification List, Pg 16 Original policy
0339T	Emerging technology/new indications for existing technology	Medicare Advantage and Dual Eligible Special Needs Plans Prior Authorization and Notification List, Pg 16 Original policy
0446T	Emerging technology/new indications for existing technology	Medicare Advantage and Dual Eligible Special Needs Plans Prior Authorization and Notification List, Pg 16 Original policy
0447T	Emerging technology/new indications for existing technology	Medicare Advantage and Dual Eligible Special Needs Plans Prior Authorization and Notification List, Pg 16 Original policy
0448T	Emerging technology/new indications for existing technology	Medicare Advantage and Dual Eligible Special Needs Plans Prior Authorization and Notification List, Pg 16 Original policy
0716T	Emerging technology/new indications for existing technology	Medicare Advantage and Dual Eligible Special Needs Plans Prior Authorization and Notification List, Pg 16 Original policy
0745T	Emerging technology/new indications for existing technology	Medicare Advantage and Dual Eligible Special Needs Plans Prior Authorization and Notification List, Pg 16 Original policy
0746T	Emerging technology/new indications for existing technology	Medicare Advantage and Dual Eligible Special Needs Plans Prior Authorization and Notification List, Pg 16 Original policy
0747T	Emerging technology/new indications for existing technology	Medicare Advantage and Dual Eligible Special Needs Plans Prior Authorization and Notification List, Pg 16 Original policy
0935T	Emerging technology/new indications for existing technology	Medicare Advantage and Dual Eligible Special Needs Plans Prior Authorization and Notification List, Pg 16 Original policy
0947T	Emerging technology/new indications for existing technology	Medicare Advantage and Dual Eligible Special Needs Plans Prior Authorization and Notification List, Pg 16 Original policy
C1735	Emerging technology/new indications for existing technology	Medicare Advantage and Dual Eligible Special Needs Plans Prior Authorization and Notification List, Pg 16 Original policy
C1736	Emerging technology/new indications for existing technology	Medicare Advantage and Dual Eligible Special Needs Plans Prior Authorization and Notification List, Pg 16 Original policy
E0738	Emerging technology/new indications for existing technology	Medicare Advantage and Dual Eligible Special Needs Plans Prior Authorization and Notification List, Pg 16 Original policy
E0739	Emerging technology/new indications for existing technology	Medicare Advantage and Dual Eligible Special Needs Plans Prior Authorization and Notification List, Pg 16 Original policy
62320	Epidural injections (outpatient only)	Medicare Advantage and Dual Eligible Special Needs Plans Prior Authorization and Notification List, Pg 16 Original policy
62321	Epidural injections (outpatient only)	Medicare Advantage and Dual Eligible Special Needs Plans Prior Authorization and Notification List, Pg 16 Original policy
62322	Epidural injections (outpatient only)	Medicare Advantage and Dual Eligible Special Needs Plans Prior Authorization and Notification List, Pg 16 Original policy
62323	Epidural injections (outpatient only)	Medicare Advantage and Dual Eligible Special Needs Plans Prior Authorization and Notification List, Pg 16 Original policy
64479	Epidural injections (outpatient only)	Medicare Advantage and Dual Eligible Special Needs Plans Prior Authorization and Notification List, Pg 16 Original policy
64480	Epidural injections (outpatient only)	Medicare Advantage and Dual Eligible Special Needs Plans Prior Authorization and Notification List, Pg 16 Original policy
64483	Epidural injections (outpatient only)	Medicare Advantage and Dual Eligible Special Needs Plans Prior Authorization and Notification List, Pg 16 Original policy
64484	Epidural injections (outpatient only)	Medicare Advantage and Dual Eligible Special Needs Plans Prior Authorization and Notification List, Pg 16 Original policy
64999	Epidural injections (outpatient only)	Medicare Advantage and Dual Eligible Special Needs Plans Prior Authorization and Notification List, Pg 16 Original policy
43235	Esophagogastroduodenoscopy (EGD)	Medicare Advantage and Dual Eligible Special Needs Plans Prior Authorization and Notification List, Pg 16 Original policy
43237	Esophagogastroduodenoscopy (EGD)	Medicare Advantage and Dual Eligible Special Needs Plans Prior Authorization and Notification List, Pg 16 Original policy
43238	Esophagogastroduodenoscopy (EGD)	Medicare Advantage and Dual Eligible Special Needs Plans Prior Authorization and Notification List, Pg 16 Original policy
43239	Esophagogastroduodenoscopy (EGD)	Medicare Advantage and Dual Eligible Special Needs Plans Prior Authorization and Notification List, Pg 16 Original policy
43242	Esophagogastroduodenoscopy (EGD)	Medicare Advantage and Dual Eligible Special Needs Plans Prior Authorization and Notification List, Pg 16 Original policy
43252	Esophagogastroduodenoscopy (EGD)	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.