Humana prior authorization, page 5
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
| Code | Description | Source |
|---|---|---|
| C1785 | Cardiac implantable devices (e.g., CardioMEMS pacemakers, leadless pacemakers, left atrial appendage closure [LAAC], defibrillators [implantable and subcutaneous] and cardiac resynchronization therapy) | Medicare Advantage and Dual Eligible Special Needs Plans Prior Authorization and Notification List, Pg 9 Original policy |
| C1786 | Cardiac implantable devices (e.g., CardioMEMS pacemakers, leadless pacemakers, left atrial appendage closure [LAAC], defibrillators [implantable and subcutaneous] and cardiac resynchronization therapy) | Medicare Advantage and Dual Eligible Special Needs Plans Prior Authorization and Notification List, Pg 9 Original policy |
| C1824 | Cardiac implantable devices (e.g., CardioMEMS pacemakers, leadless pacemakers, left atrial appendage closure [LAAC], defibrillators [implantable and subcutaneous] and cardiac resynchronization therapy) | Medicare Advantage and Dual Eligible Special Needs Plans Prior Authorization and Notification List, Pg 9 Original policy |
| C1882 | Cardiac implantable devices (e.g., CardioMEMS pacemakers, leadless pacemakers, left atrial appendage closure [LAAC], defibrillators [implantable and subcutaneous] and cardiac resynchronization therapy) | Medicare Advantage and Dual Eligible Special Needs Plans Prior Authorization and Notification List, Pg 9 Original policy |
| C1895 | Cardiac implantable devices (e.g., CardioMEMS pacemakers, leadless pacemakers, left atrial appendage closure [LAAC], defibrillators [implantable and subcutaneous] and cardiac resynchronization therapy) | Medicare Advantage and Dual Eligible Special Needs Plans Prior Authorization and Notification List, Pg 9 Original policy |
| C1896 | Cardiac implantable devices (e.g., CardioMEMS pacemakers, leadless pacemakers, left atrial appendage closure [LAAC], defibrillators [implantable and subcutaneous] and cardiac resynchronization therapy) | Medicare Advantage and Dual Eligible Special Needs Plans Prior Authorization and Notification List, Pg 9 Original policy |
| C1898 | Cardiac implantable devices (e.g., CardioMEMS pacemakers, leadless pacemakers, left atrial appendage closure [LAAC], defibrillators [implantable and subcutaneous] and cardiac resynchronization therapy) | Medicare Advantage and Dual Eligible Special Needs Plans Prior Authorization and Notification List, Pg 9 Original policy |
| C1899 | Cardiac implantable devices (e.g., CardioMEMS pacemakers, leadless pacemakers, left atrial appendage closure [LAAC], defibrillators [implantable and subcutaneous] and cardiac resynchronization therapy) | Medicare Advantage and Dual Eligible Special Needs Plans Prior Authorization and Notification List, Pg 9 Original policy |
| C1900 | Cardiac implantable devices (e.g., CardioMEMS pacemakers, leadless pacemakers, left atrial appendage closure [LAAC], defibrillators [implantable and subcutaneous] and cardiac resynchronization therapy) | Medicare Advantage and Dual Eligible Special Needs Plans Prior Authorization and Notification List, Pg 9 Original policy |
| C2619 | Cardiac implantable devices (e.g., CardioMEMS pacemakers, leadless pacemakers, left atrial appendage closure [LAAC], defibrillators [implantable and subcutaneous] and cardiac resynchronization therapy) | Medicare Advantage and Dual Eligible Special Needs Plans Prior Authorization and Notification List, Pg 9 Original policy |
| C2620 | Cardiac implantable devices (e.g., CardioMEMS pacemakers, leadless pacemakers, left atrial appendage closure [LAAC], defibrillators [implantable and subcutaneous] and cardiac resynchronization therapy) | Medicare Advantage and Dual Eligible Special Needs Plans Prior Authorization and Notification List, Pg 9 Original policy |
| C2621 | Cardiac implantable devices (e.g., CardioMEMS pacemakers, leadless pacemakers, left atrial appendage closure [LAAC], defibrillators [implantable and subcutaneous] and cardiac resynchronization therapy) | Medicare Advantage and Dual Eligible Special Needs Plans Prior Authorization and Notification List, Pg 9 Original policy |
| C2624 | Cardiac implantable devices (e.g., CardioMEMS pacemakers, leadless pacemakers, left atrial appendage closure [LAAC], defibrillators [implantable and subcutaneous] and cardiac resynchronization therapy) | Medicare Advantage and Dual Eligible Special Needs Plans Prior Authorization and Notification List, Pg 9 Original policy |
| G0555 | Cardiac implantable devices (e.g., CardioMEMS pacemakers, leadless pacemakers, left atrial appendage closure [LAAC], defibrillators [implantable and subcutaneous] and cardiac resynchronization therapy) | Medicare Advantage and Dual Eligible Special Needs Plans Prior Authorization and Notification List, Pg 9 Original policy |
| 64654 | Implantable Carotid Sinus | Medicare Advantage and Dual Eligible Special Needs Plans Prior Authorization and Notification List, Pg 9 Original policy |
| 64655 | Implantable Carotid Sinus | Medicare Advantage and Dual Eligible Special Needs Plans Prior Authorization and Notification List, Pg 9 Original policy |
| 64656 | Implantable Carotid Sinus | Medicare Advantage and Dual Eligible Special Needs Plans Prior Authorization and Notification List, Pg 9 Original policy |
| 64657 | Stimulator | Medicare Advantage and Dual Eligible Special Needs Plans Prior Authorization and Notification List, Pg 9 Original policy |
| 64658 | Stimulator | Medicare Advantage and Dual Eligible Special Needs Plans Prior Authorization and Notification List, Pg 9 Original policy |
| 64659 | Stimulator | Medicare Advantage and Dual Eligible Special Needs Plans Prior Authorization and Notification List, Pg 9 Original policy |
| 93145 | Stimulator | Medicare Advantage and Dual Eligible Special Needs Plans Prior Authorization and Notification List, Pg 9 Original policy |
| 93146 | Stimulator | Medicare Advantage and Dual Eligible Special Needs Plans Prior Authorization and Notification List, Pg 9 Original policy |
| C1825 | Stimulator | Medicare Advantage and Dual Eligible Special Needs Plans Prior Authorization and Notification List, Pg 9 Original policy |
| 33285 | Internal loop recorders | Medicare Advantage and Dual Eligible Special Needs Plans Prior Authorization and Notification List, Pg 9 Original policy |
| 33286 | Internal loop recorders | Medicare Advantage and Dual Eligible Special Needs Plans Prior Authorization and Notification List, Pg 9 Original policy |
| 93228 | Wearable cardiac monitoring devices | Medicare Advantage and Dual Eligible Special Needs Plans Prior Authorization and Notification List, Pg 10 Original policy |
| 93229 | Wearable cardiac monitoring devices | Medicare Advantage and Dual Eligible Special Needs Plans Prior Authorization and Notification List, Pg 10 Original policy |
| 93451 | Cardiac catheterizations Carotid revascularization | Medicare Advantage and Dual Eligible Special Needs Plans Prior Authorization and Notification List, Pg 10 Original policy |
| 93452 | Cardiac catheterizations Carotid revascularization | Medicare Advantage and Dual Eligible Special Needs Plans Prior Authorization and Notification List, Pg 10 Original policy |
| 93453 | Cardiac catheterizations Carotid revascularization | Medicare Advantage and Dual Eligible Special Needs Plans Prior Authorization and Notification List, Pg 10 Original policy |
| 93454 | Cardiac catheterizations Carotid revascularization | Medicare Advantage and Dual Eligible Special Needs Plans Prior Authorization and Notification List, Pg 10 Original policy |
| 93455 | Cardiac catheterizations Carotid revascularization | Medicare Advantage and Dual Eligible Special Needs Plans Prior Authorization and Notification List, Pg 10 Original policy |
| 93456 | Cardiac catheterizations Carotid revascularization | Medicare Advantage and Dual Eligible Special Needs Plans Prior Authorization and Notification List, Pg 10 Original policy |
| 93457 | Cardiac catheterizations Carotid revascularization | Medicare Advantage and Dual Eligible Special Needs Plans Prior Authorization and Notification List, Pg 10 Original policy |
| 93458 | Cardiac catheterizations Carotid revascularization | Medicare Advantage and Dual Eligible Special Needs Plans Prior Authorization and Notification List, Pg 10 Original policy |
| 93459 | Cardiac catheterizations Carotid revascularization | Medicare Advantage and Dual Eligible Special Needs Plans Prior Authorization and Notification List, Pg 10 Original policy |
| 93460 | Cardiac catheterizations Carotid revascularization | Medicare Advantage and Dual Eligible Special Needs Plans Prior Authorization and Notification List, Pg 10 Original policy |
| 93461 | Cardiac catheterizations Carotid revascularization | Medicare Advantage and Dual Eligible Special Needs Plans Prior Authorization and Notification List, Pg 10 Original policy |
| 93593 | Cardiac catheterizations Carotid revascularization | Medicare Advantage and Dual Eligible Special Needs Plans Prior Authorization and Notification List, Pg 10 Original policy |
| 93594 | Cardiac catheterizations Carotid revascularization | Medicare Advantage and Dual Eligible Special Needs Plans Prior Authorization and Notification List, Pg 10 Original policy |
| 93595 | Cardiac catheterizations Carotid revascularization | Medicare Advantage and Dual Eligible Special Needs Plans Prior Authorization and Notification List, Pg 10 Original policy |
| 93596 | Cardiac catheterizations Carotid revascularization | Medicare Advantage and Dual Eligible Special Needs Plans Prior Authorization and Notification List, Pg 10 Original policy |
| 93597 | Cardiac catheterizations Carotid revascularization | Medicare Advantage and Dual Eligible Special Needs Plans Prior Authorization and Notification List, Pg 10 Original policy |
| 35301 | Cardiac catheterizations Carotid revascularization | Medicare Advantage and Dual Eligible Special Needs Plans Prior Authorization and Notification List, Pg 10 Original policy |
| 37215 | Cardiac catheterizations Carotid revascularization | Medicare Advantage and Dual Eligible Special Needs Plans Prior Authorization and Notification List, Pg 10 Original policy |
| 37216 | Cardiac catheterizations Carotid revascularization | Medicare Advantage and Dual Eligible Special Needs Plans Prior Authorization and Notification List, Pg 10 Original policy |
| 37217 | Cardiac catheterizations Carotid revascularization | Medicare Advantage and Dual Eligible Special Needs Plans Prior Authorization and Notification List, Pg 10 Original policy |
| 37218 | Cardiac catheterizations Carotid revascularization | Medicare Advantage and Dual Eligible Special Needs Plans Prior Authorization and Notification List, Pg 10 Original policy |
| 92920 | Cardiac catheterizations Carotid revascularization | Medicare Advantage and Dual Eligible Special Needs Plans Prior Authorization and Notification List, Pg 10 Original policy |
| 92924 | Cardiac catheterizations Carotid revascularization | Medicare Advantage and Dual Eligible Special Needs Plans Prior Authorization and Notification List, Pg 10 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