Humana prior authorization, page 24

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
21081	Prosthetics	Medicare Advantage and Dual Eligible Special Needs Plans Prior Authorization and Notification List, Pg 32 Original policy
21082	Prosthetics	Medicare Advantage and Dual Eligible Special Needs Plans Prior Authorization and Notification List, Pg 32 Original policy
21084	Prosthetics	Medicare Advantage and Dual Eligible Special Needs Plans Prior Authorization and Notification List, Pg 32 Original policy
A9282	Prosthetics	Medicare Advantage and Dual Eligible Special Needs Plans Prior Authorization and Notification List, Pg 32 Original policy
L5000	Prosthetics	Medicare Advantage and Dual Eligible Special Needs Plans Prior Authorization and Notification List, Pg 32 Original policy
L5010	Prosthetics	Medicare Advantage and Dual Eligible Special Needs Plans Prior Authorization and Notification List, Pg 32 Original policy
L5020	Prosthetics	Medicare Advantage and Dual Eligible Special Needs Plans Prior Authorization and Notification List, Pg 32 Original policy
L5050	Prosthetics	Medicare Advantage and Dual Eligible Special Needs Plans Prior Authorization and Notification List, Pg 32 Original policy
L5060	Prosthetics	Medicare Advantage and Dual Eligible Special Needs Plans Prior Authorization and Notification List, Pg 32 Original policy
L5100	Prosthetics	Medicare Advantage and Dual Eligible Special Needs Plans Prior Authorization and Notification List, Pg 32 Original policy
L5105	Prosthetics	Medicare Advantage and Dual Eligible Special Needs Plans Prior Authorization and Notification List, Pg 32 Original policy
L5150	Prosthetics	Medicare Advantage and Dual Eligible Special Needs Plans Prior Authorization and Notification List, Pg 32 Original policy
L5160	Prosthetics	Medicare Advantage and Dual Eligible Special Needs Plans Prior Authorization and Notification List, Pg 32 Original policy
L5200	Prosthetics	Medicare Advantage and Dual Eligible Special Needs Plans Prior Authorization and Notification List, Pg 32 Original policy
L5210	Prosthetics	Medicare Advantage and Dual Eligible Special Needs Plans Prior Authorization and Notification List, Pg 32 Original policy
L5220	Prosthetics	Medicare Advantage and Dual Eligible Special Needs Plans Prior Authorization and Notification List, Pg 32 Original policy
L5230	Prosthetics	Medicare Advantage and Dual Eligible Special Needs Plans Prior Authorization and Notification List, Pg 32 Original policy
L5250	Prosthetics	Medicare Advantage and Dual Eligible Special Needs Plans Prior Authorization and Notification List, Pg 32 Original policy
L5270	Prosthetics	Medicare Advantage and Dual Eligible Special Needs Plans Prior Authorization and Notification List, Pg 32 Original policy
L5280	Prosthetics	Medicare Advantage and Dual Eligible Special Needs Plans Prior Authorization and Notification List, Pg 32 Original policy
L5301	Prosthetics	Medicare Advantage and Dual Eligible Special Needs Plans Prior Authorization and Notification List, Pg 32 Original policy
L5312	Prosthetics	Medicare Advantage and Dual Eligible Special Needs Plans Prior Authorization and Notification List, Pg 32 Original policy
L5321	Prosthetics	Medicare Advantage and Dual Eligible Special Needs Plans Prior Authorization and Notification List, Pg 32 Original policy
L5331	Prosthetics	Medicare Advantage and Dual Eligible Special Needs Plans Prior Authorization and Notification List, Pg 32 Original policy
L5341	Prosthetics	Medicare Advantage and Dual Eligible Special Needs Plans Prior Authorization and Notification List, Pg 32 Original policy
L5420	Prosthetics	Medicare Advantage and Dual Eligible Special Needs Plans Prior Authorization and Notification List, Pg 32 Original policy
L5500	Prosthetics	Medicare Advantage and Dual Eligible Special Needs Plans Prior Authorization and Notification List, Pg 32 Original policy
L5505	Prosthetics	Medicare Advantage and Dual Eligible Special Needs Plans Prior Authorization and Notification List, Pg 32 Original policy
L5510	Prosthetics	Medicare Advantage and Dual Eligible Special Needs Plans Prior Authorization and Notification List, Pg 32 Original policy
L5520	Prosthetics	Medicare Advantage and Dual Eligible Special Needs Plans Prior Authorization and Notification List, Pg 32 Original policy
L5530	Prosthetics	Medicare Advantage and Dual Eligible Special Needs Plans Prior Authorization and Notification List, Pg 32 Original policy
L5535	Prosthetics	Medicare Advantage and Dual Eligible Special Needs Plans Prior Authorization and Notification List, Pg 32 Original policy
L5540	Prosthetics	Medicare Advantage and Dual Eligible Special Needs Plans Prior Authorization and Notification List, Pg 32 Original policy
32701	Radiation therapy	Medicare Advantage and Dual Eligible Special Needs Plans Prior Authorization and Notification List, Pg 35 Original policy
61796	Radiation therapy	Medicare Advantage and Dual Eligible Special Needs Plans Prior Authorization and Notification List, Pg 35 Original policy
61798	Radiation therapy	Medicare Advantage and Dual Eligible Special Needs Plans Prior Authorization and Notification List, Pg 35 Original policy
63620	Radiation therapy	Medicare Advantage and Dual Eligible Special Needs Plans Prior Authorization and Notification List, Pg 35 Original policy
77280	Radiation therapy	Medicare Advantage and Dual Eligible Special Needs Plans Prior Authorization and Notification List, Pg 35 Original policy
77290	Radiation therapy	Medicare Advantage and Dual Eligible Special Needs Plans Prior Authorization and Notification List, Pg 35 Original policy
77295	Radiation therapy	Medicare Advantage and Dual Eligible Special Needs Plans Prior Authorization and Notification List, Pg 35 Original policy
77301	Radiation therapy	Medicare Advantage and Dual Eligible Special Needs Plans Prior Authorization and Notification List, Pg 35 Original policy
77338	Radiation therapy	Medicare Advantage and Dual Eligible Special Needs Plans Prior Authorization and Notification List, Pg 35 Original policy
77371	Radiation therapy	Medicare Advantage and Dual Eligible Special Needs Plans Prior Authorization and Notification List, Pg 35 Original policy
77372	Radiation therapy	Medicare Advantage and Dual Eligible Special Needs Plans Prior Authorization and Notification List, Pg 35 Original policy
77373	Radiation therapy	Medicare Advantage and Dual Eligible Special Needs Plans Prior Authorization and Notification List, Pg 35 Original policy
77387*	Radiation therapy	Medicare Advantage and Dual Eligible Special Needs Plans Prior Authorization and Notification List, Pg 35 Original policy
77402	Radiation therapy	Medicare Advantage and Dual Eligible Special Needs Plans Prior Authorization and Notification List, Pg 35 Original policy
77407	Radiation therapy	Medicare Advantage and Dual Eligible Special Needs Plans Prior Authorization and Notification List, Pg 35 Original policy
77412	Radiation therapy	Medicare Advantage and Dual Eligible Special Needs Plans Prior Authorization and Notification List, Pg 35 Original policy
77423	Radiation therapy	Medicare Advantage and Dual Eligible Special Needs Plans Prior Authorization and Notification List, Pg 35 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.