Humana prior authorization, page 23

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
37238	nboarding information: m/provider/resources (online): request a new account: nboarding information: m/provider/resources	Medicare Advantage and Dual Eligible Special Needs Plans Prior Authorization and Notification List, Pg 31 Original policy
37254	nboarding information: m/provider/resources (online): request a new account: nboarding information: m/provider/resources	Medicare Advantage and Dual Eligible Special Needs Plans Prior Authorization and Notification List, Pg 31 Original policy
37256	nboarding information: m/provider/resources (online): request a new account: nboarding information: m/provider/resources	Medicare Advantage and Dual Eligible Special Needs Plans Prior Authorization and Notification List, Pg 31 Original policy
37258	nboarding information: m/provider/resources (online): request a new account: nboarding information: m/provider/resources	Medicare Advantage and Dual Eligible Special Needs Plans Prior Authorization and Notification List, Pg 31 Original policy
37260	nboarding information: m/provider/resources (online): request a new account: nboarding information: m/provider/resources	Medicare Advantage and Dual Eligible Special Needs Plans Prior Authorization and Notification List, Pg 31 Original policy
37262*	nboarding information: m/provider/resources (online): request a new account: nboarding information: m/provider/resources	Medicare Advantage and Dual Eligible Special Needs Plans Prior Authorization and Notification List, Pg 31 Original policy
37263	nboarding information: m/provider/resources (online): request a new account: nboarding information: m/provider/resources	Medicare Advantage and Dual Eligible Special Needs Plans Prior Authorization and Notification List, Pg 31 Original policy
37265	nboarding information: m/provider/resources (online): request a new account: nboarding information: m/provider/resources	Medicare Advantage and Dual Eligible Special Needs Plans Prior Authorization and Notification List, Pg 31 Original policy
37267	nboarding information: m/provider/resources (online): request a new account: nboarding information: m/provider/resources	Medicare Advantage and Dual Eligible Special Needs Plans Prior Authorization and Notification List, Pg 31 Original policy
37269	nboarding information: m/provider/resources (online): request a new account: nboarding information: m/provider/resources	Medicare Advantage and Dual Eligible Special Needs Plans Prior Authorization and Notification List, Pg 31 Original policy
37271	nboarding information: m/provider/resources (online): request a new account: nboarding information: m/provider/resources	Medicare Advantage and Dual Eligible Special Needs Plans Prior Authorization and Notification List, Pg 31 Original policy
37273	nboarding information: m/provider/resources (online): request a new account: nboarding information: m/provider/resources	Medicare Advantage and Dual Eligible Special Needs Plans Prior Authorization and Notification List, Pg 31 Original policy
37275	nboarding information: m/provider/resources (online): request a new account: nboarding information: m/provider/resources	Medicare Advantage and Dual Eligible Special Needs Plans Prior Authorization and Notification List, Pg 31 Original policy
37277	nboarding information: m/provider/resources (online): request a new account: nboarding information: m/provider/resources	Medicare Advantage and Dual Eligible Special Needs Plans Prior Authorization and Notification List, Pg 31 Original policy
37279*	nboarding information: m/provider/resources (online): request a new account: nboarding information: m/provider/resources	Medicare Advantage and Dual Eligible Special Needs Plans Prior Authorization and Notification List, Pg 31 Original policy
37280	nboarding information: m/provider/resources (online): request a new account: nboarding information: m/provider/resources	Medicare Advantage and Dual Eligible Special Needs Plans Prior Authorization and Notification List, Pg 31 Original policy
37282	nboarding information: m/provider/resources (online): request a new account: nboarding information: m/provider/resources	Medicare Advantage and Dual Eligible Special Needs Plans Prior Authorization and Notification List, Pg 31 Original policy
37284	nboarding information: m/provider/resources (online): request a new account: nboarding information: m/provider/resources	Medicare Advantage and Dual Eligible Special Needs Plans Prior Authorization and Notification List, Pg 31 Original policy
37286	nboarding information: m/provider/resources (online): request a new account: nboarding information: m/provider/resources	Medicare Advantage and Dual Eligible Special Needs Plans Prior Authorization and Notification List, Pg 31 Original policy
37288	nboarding information: m/provider/resources (online): request a new account: nboarding information: m/provider/resources	Medicare Advantage and Dual Eligible Special Needs Plans Prior Authorization and Notification List, Pg 31 Original policy
37290	nboarding information: m/provider/resources (online): request a new account: nboarding information: m/provider/resources	Medicare Advantage and Dual Eligible Special Needs Plans Prior Authorization and Notification List, Pg 31 Original policy
37292	nboarding information: m/provider/resources (online): request a new account: nboarding information: m/provider/resources	Medicare Advantage and Dual Eligible Special Needs Plans Prior Authorization and Notification List, Pg 31 Original policy
37294	nboarding information: m/provider/resources (online): request a new account: nboarding information: m/provider/resources	Medicare Advantage and Dual Eligible Special Needs Plans Prior Authorization and Notification List, Pg 31 Original policy
37296	nboarding information: m/provider/resources (online): request a new account: nboarding information: m/provider/resources	Medicare Advantage and Dual Eligible Special Needs Plans Prior Authorization and Notification List, Pg 31 Original policy
37298	nboarding information: m/provider/resources (online): request a new account: nboarding information: m/provider/resources	Medicare Advantage and Dual Eligible Special Needs Plans Prior Authorization and Notification List, Pg 31 Original policy
0505T	nboarding information: m/provider/resources (online): request a new account: nboarding information: m/provider/resources	Medicare Advantage and Dual Eligible Special Needs Plans Prior Authorization and Notification List, Pg 31 Original policy
C9764	nboarding information: m/provider/resources (online): request a new account: nboarding information: m/provider/resources	Medicare Advantage and Dual Eligible Special Needs Plans Prior Authorization and Notification List, Pg 31 Original policy
C9765	nboarding information: m/provider/resources (online): request a new account: nboarding information: m/provider/resources	Medicare Advantage and Dual Eligible Special Needs Plans Prior Authorization and Notification List, Pg 31 Original policy
C9766	nboarding information: m/provider/resources (online): request a new account: nboarding information: m/provider/resources	Medicare Advantage and Dual Eligible Special Needs Plans Prior Authorization and Notification List, Pg 31 Original policy
C9767	nboarding information: m/provider/resources (online): request a new account: nboarding information: m/provider/resources	Medicare Advantage and Dual Eligible Special Needs Plans Prior Authorization and Notification List, Pg 31 Original policy
C9772	nboarding information: m/provider/resources (online): request a new account: nboarding information: m/provider/resources	Medicare Advantage and Dual Eligible Special Needs Plans Prior Authorization and Notification List, Pg 31 Original policy
C9773	nboarding information: m/provider/resources (online): request a new account: nboarding information: m/provider/resources	Medicare Advantage and Dual Eligible Special Needs Plans Prior Authorization and Notification List, Pg 31 Original policy
C9774	nboarding information: m/provider/resources (online): request a new account: nboarding information: m/provider/resources	Medicare Advantage and Dual Eligible Special Needs Plans Prior Authorization and Notification List, Pg 31 Original policy
C9775	nboarding information: m/provider/resources (online): request a new account: nboarding information: m/provider/resources	Medicare Advantage and Dual Eligible Special Needs Plans Prior Authorization and Notification List, Pg 31 Original policy
37242	nboarding information: m/provider/resources (online): request a new account: nboarding information: m/provider/resources	Medicare Advantage and Dual Eligible Special Needs Plans Prior Authorization and Notification List, Pg 31 Original policy
37243	nboarding information: m/provider/resources (online): request a new account: nboarding information: m/provider/resources	Medicare Advantage and Dual Eligible Special Needs Plans Prior Authorization and Notification List, Pg 31 Original policy
55801	Prostate surgeries (prostatectomy)	Medicare Advantage and Dual Eligible Special Needs Plans Prior Authorization and Notification List, Pg 32 Original policy
55810	Prostate surgeries (prostatectomy)	Medicare Advantage and Dual Eligible Special Needs Plans Prior Authorization and Notification List, Pg 32 Original policy
55812	Prostate surgeries (prostatectomy)	Medicare Advantage and Dual Eligible Special Needs Plans Prior Authorization and Notification List, Pg 32 Original policy
55815	Prostate surgeries (prostatectomy)	Medicare Advantage and Dual Eligible Special Needs Plans Prior Authorization and Notification List, Pg 32 Original policy
55821	Prostate surgeries (prostatectomy)	Medicare Advantage and Dual Eligible Special Needs Plans Prior Authorization and Notification List, Pg 32 Original policy
55831	Prostate surgeries (prostatectomy)	Medicare Advantage and Dual Eligible Special Needs Plans Prior Authorization and Notification List, Pg 32 Original policy
55840	Prostate surgeries (prostatectomy)	Medicare Advantage and Dual Eligible Special Needs Plans Prior Authorization and Notification List, Pg 32 Original policy
55842	Prostate surgeries (prostatectomy)	Medicare Advantage and Dual Eligible Special Needs Plans Prior Authorization and Notification List, Pg 32 Original policy
55845	Prostate surgeries (prostatectomy)	Medicare Advantage and Dual Eligible Special Needs Plans Prior Authorization and Notification List, Pg 32 Original policy
55866	Prostate surgeries (prostatectomy)	Medicare Advantage and Dual Eligible Special Needs Plans Prior Authorization and Notification List, Pg 32 Original policy
55867	Prostate surgeries (prostatectomy)	Medicare Advantage and Dual Eligible Special Needs Plans Prior Authorization and Notification List, Pg 32 Original policy
55868	Prostate surgeries (prostatectomy)	Medicare Advantage and Dual Eligible Special Needs Plans Prior Authorization and Notification List, Pg 32 Original policy
55869	Prostate surgeries (prostatectomy)	Medicare Advantage and Dual Eligible Special Needs Plans Prior Authorization and Notification List, Pg 32 Original policy
55880	Prostate surgeries (prostatectomy)	Medicare Advantage and Dual Eligible Special Needs Plans Prior Authorization and Notification List, Pg 32 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.