Humana prior authorization, page 28

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
63042	For questions, call	Medicare Advantage and Dual Eligible Special Needs Plans Prior Authorization and Notification List, Pg 41 Original policy
63043	For questions, call	Medicare Advantage and Dual Eligible Special Needs Plans Prior Authorization and Notification List, Pg 41 Original policy
63044	For questions, call	Medicare Advantage and Dual Eligible Special Needs Plans Prior Authorization and Notification List, Pg 41 Original policy
63045	For questions, call	Medicare Advantage and Dual Eligible Special Needs Plans Prior Authorization and Notification List, Pg 41 Original policy
63046	For questions, call	Medicare Advantage and Dual Eligible Special Needs Plans Prior Authorization and Notification List, Pg 41 Original policy
63047	For questions, call	Medicare Advantage and Dual Eligible Special Needs Plans Prior Authorization and Notification List, Pg 41 Original policy
21685	Surgery for obstructive sleep apnea	Medicare Advantage and Dual Eligible Special Needs Plans Prior Authorization and Notification List, Pg 42 Original policy
33276	Surgery for obstructive sleep apnea	Medicare Advantage and Dual Eligible Special Needs Plans Prior Authorization and Notification List, Pg 42 Original policy
33277	Surgery for obstructive sleep apnea	Medicare Advantage and Dual Eligible Special Needs Plans Prior Authorization and Notification List, Pg 42 Original policy
33278	Surgery for obstructive sleep apnea	Medicare Advantage and Dual Eligible Special Needs Plans Prior Authorization and Notification List, Pg 42 Original policy
33279	Surgery for obstructive sleep apnea	Medicare Advantage and Dual Eligible Special Needs Plans Prior Authorization and Notification List, Pg 42 Original policy
33280	Surgery for obstructive sleep apnea	Medicare Advantage and Dual Eligible Special Needs Plans Prior Authorization and Notification List, Pg 42 Original policy
33281	Surgery for obstructive sleep apnea	Medicare Advantage and Dual Eligible Special Needs Plans Prior Authorization and Notification List, Pg 42 Original policy
33287	Surgery for obstructive sleep apnea	Medicare Advantage and Dual Eligible Special Needs Plans Prior Authorization and Notification List, Pg 42 Original policy
33288	Surgery for obstructive sleep apnea	Medicare Advantage and Dual Eligible Special Needs Plans Prior Authorization and Notification List, Pg 42 Original policy
41512	Surgery for obstructive sleep apnea	Medicare Advantage and Dual Eligible Special Needs Plans Prior Authorization and Notification List, Pg 42 Original policy
41530	Surgery for obstructive sleep apnea	Medicare Advantage and Dual Eligible Special Needs Plans Prior Authorization and Notification List, Pg 42 Original policy
41599	Surgery for obstructive sleep apnea	Medicare Advantage and Dual Eligible Special Needs Plans Prior Authorization and Notification List, Pg 42 Original policy
42140	Surgery for obstructive sleep apnea	Medicare Advantage and Dual Eligible Special Needs Plans Prior Authorization and Notification List, Pg 42 Original policy
42145	Surgery for obstructive sleep apnea	Medicare Advantage and Dual Eligible Special Needs Plans Prior Authorization and Notification List, Pg 42 Original policy
42299	Surgery for obstructive sleep apnea	Medicare Advantage and Dual Eligible Special Needs Plans Prior Authorization and Notification List, Pg 42 Original policy
42950	Surgery for obstructive sleep apnea	Medicare Advantage and Dual Eligible Special Needs Plans Prior Authorization and Notification List, Pg 42 Original policy
64582	Surgery for obstructive sleep apnea	Medicare Advantage and Dual Eligible Special Needs Plans Prior Authorization and Notification List, Pg 42 Original policy
93150	Surgery for obstructive sleep apnea	Medicare Advantage and Dual Eligible Special Needs Plans Prior Authorization and Notification List, Pg 42 Original policy
93151	Surgery for obstructive sleep apnea	Medicare Advantage and Dual Eligible Special Needs Plans Prior Authorization and Notification List, Pg 42 Original policy
93152	Surgery for obstructive sleep apnea	Medicare Advantage and Dual Eligible Special Needs Plans Prior Authorization and Notification List, Pg 42 Original policy
93153	Surgery for obstructive sleep apnea	Medicare Advantage and Dual Eligible Special Needs Plans Prior Authorization and Notification List, Pg 42 Original policy
31237	Excludes diagnostic nasal/sinus endoscopies	Medicare Advantage and Dual Eligible Special Needs Plans Prior Authorization and Notification List, Pg 42 Original policy
31240	Excludes diagnostic nasal/sinus endoscopies	Medicare Advantage and Dual Eligible Special Needs Plans Prior Authorization and Notification List, Pg 42 Original policy
31242	Excludes diagnostic nasal/sinus endoscopies	Medicare Advantage and Dual Eligible Special Needs Plans Prior Authorization and Notification List, Pg 42 Original policy
31243	Excludes diagnostic nasal/sinus endoscopies	Medicare Advantage and Dual Eligible Special Needs Plans Prior Authorization and Notification List, Pg 42 Original policy
31253	Excludes diagnostic nasal/sinus endoscopies	Medicare Advantage and Dual Eligible Special Needs Plans Prior Authorization and Notification List, Pg 42 Original policy
31254	Excludes diagnostic nasal/sinus endoscopies	Medicare Advantage and Dual Eligible Special Needs Plans Prior Authorization and Notification List, Pg 42 Original policy
31255	dilation	Medicare Advantage and Dual Eligible Special Needs Plans Prior Authorization and Notification List, Pg 42 Original policy
31256	dilation	Medicare Advantage and Dual Eligible Special Needs Plans Prior Authorization and Notification List, Pg 42 Original policy
31257	dilation	Medicare Advantage and Dual Eligible Special Needs Plans Prior Authorization and Notification List, Pg 42 Original policy
97010	Therapy (physical and occupational)	Medicare Advantage and Dual Eligible Special Needs Plans Prior Authorization and Notification List, Pg 43 Original policy
97012	Therapy (physical and occupational)	Medicare Advantage and Dual Eligible Special Needs Plans Prior Authorization and Notification List, Pg 43 Original policy
97014	Therapy (physical and occupational)	Medicare Advantage and Dual Eligible Special Needs Plans Prior Authorization and Notification List, Pg 43 Original policy
97016	Therapy (physical and occupational)	Medicare Advantage and Dual Eligible Special Needs Plans Prior Authorization and Notification List, Pg 43 Original policy
97018	Therapy (physical and occupational)	Medicare Advantage and Dual Eligible Special Needs Plans Prior Authorization and Notification List, Pg 43 Original policy
97022	Therapy (physical and occupational)	Medicare Advantage and Dual Eligible Special Needs Plans Prior Authorization and Notification List, Pg 43 Original policy
97024	Therapy (physical and occupational)	Medicare Advantage and Dual Eligible Special Needs Plans Prior Authorization and Notification List, Pg 43 Original policy
97026	Therapy (physical and occupational)	Medicare Advantage and Dual Eligible Special Needs Plans Prior Authorization and Notification List, Pg 43 Original policy
97028	Therapy (physical and occupational)	Medicare Advantage and Dual Eligible Special Needs Plans Prior Authorization and Notification List, Pg 43 Original policy
97032	Therapy (physical and occupational)	Medicare Advantage and Dual Eligible Special Needs Plans Prior Authorization and Notification List, Pg 43 Original policy
97033	Therapy (physical and occupational)	Medicare Advantage and Dual Eligible Special Needs Plans Prior Authorization and Notification List, Pg 43 Original policy
97034	Therapy (physical and occupational)	Medicare Advantage and Dual Eligible Special Needs Plans Prior Authorization and Notification List, Pg 43 Original policy
97035	Therapy (physical and occupational)	Medicare Advantage and Dual Eligible Special Needs Plans Prior Authorization and Notification List, Pg 43 Original policy
97036	Therapy (physical and occupational)	Medicare Advantage and Dual Eligible Special Needs Plans Prior Authorization and Notification List, Pg 43 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.