Humana prior authorization, page 6

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
92928	Cardiac catheterizations Carotid revascularization	Medicare Advantage and Dual Eligible Special Needs Plans Prior Authorization and Notification List, Pg 10 Original policy
92930	Cardiac catheterizations Carotid revascularization	Medicare Advantage and Dual Eligible Special Needs Plans Prior Authorization and Notification List, Pg 10 Original policy
92933	Cardiac catheterizations Carotid revascularization	Medicare Advantage and Dual Eligible Special Needs Plans Prior Authorization and Notification List, Pg 10 Original policy
92937	Cardiac catheterizations Carotid revascularization	Medicare Advantage and Dual Eligible Special Needs Plans Prior Authorization and Notification List, Pg 10 Original policy
92943	Coronary angioplasty/stent	Medicare Advantage and Dual Eligible Special Needs Plans Prior Authorization and Notification List, Pg 10 Original policy
92945	Coronary angioplasty/stent	Medicare Advantage and Dual Eligible Special Needs Plans Prior Authorization and Notification List, Pg 10 Original policy
92972	Coronary angioplasty/stent	Medicare Advantage and Dual Eligible Special Needs Plans Prior Authorization and Notification List, Pg 10 Original policy
0913T	Coronary angioplasty/stent	Medicare Advantage and Dual Eligible Special Needs Plans Prior Authorization and Notification List, Pg 10 Original policy
0914T	Coronary angioplasty/stent	Medicare Advantage and Dual Eligible Special Needs Plans Prior Authorization and Notification List, Pg 10 Original policy
C1761	Coronary angioplasty/stent	Medicare Advantage and Dual Eligible Special Needs Plans Prior Authorization and Notification List, Pg 10 Original policy
C7571	Coronary angioplasty/stent	Medicare Advantage and Dual Eligible Special Needs Plans Prior Authorization and Notification List, Pg 10 Original policy
C9600	Coronary angioplasty/stent	Medicare Advantage and Dual Eligible Special Needs Plans Prior Authorization and Notification List, Pg 10 Original policy
C9602	Coronary angioplasty/stent	Medicare Advantage and Dual Eligible Special Needs Plans Prior Authorization and Notification List, Pg 10 Original policy
C9604	Coronary angioplasty/stent	Medicare Advantage and Dual Eligible Special Needs Plans Prior Authorization and Notification List, Pg 10 Original policy
C9607	Coronary angioplasty/stent	Medicare Advantage and Dual Eligible Special Needs Plans Prior Authorization and Notification List, Pg 10 Original policy
93580	Patent foramen ovale (PFO) and atrial septal defect (ASD) closure Transcatheter valve surgeries (TMVR, TAVR/TAVI and MitraClip)	Medicare Advantage and Dual Eligible Special Needs Plans Prior Authorization and Notification List, Pg 10 Original policy
33361	Patent foramen ovale (PFO) and atrial septal defect (ASD) closure Transcatheter valve surgeries (TMVR, TAVR/TAVI and MitraClip)	Medicare Advantage and Dual Eligible Special Needs Plans Prior Authorization and Notification List, Pg 10 Original policy
33362	Patent foramen ovale (PFO) and atrial septal defect (ASD) closure Transcatheter valve surgeries (TMVR, TAVR/TAVI and MitraClip)	Medicare Advantage and Dual Eligible Special Needs Plans Prior Authorization and Notification List, Pg 10 Original policy
33363	Patent foramen ovale (PFO) and atrial septal defect (ASD) closure Transcatheter valve surgeries (TMVR, TAVR/TAVI and MitraClip)	Medicare Advantage and Dual Eligible Special Needs Plans Prior Authorization and Notification List, Pg 10 Original policy
33364	Patent foramen ovale (PFO) and atrial septal defect (ASD) closure Transcatheter valve surgeries (TMVR, TAVR/TAVI and MitraClip)	Medicare Advantage and Dual Eligible Special Needs Plans Prior Authorization and Notification List, Pg 10 Original policy
33365	Patent foramen ovale (PFO) and atrial septal defect (ASD) closure Transcatheter valve surgeries (TMVR, TAVR/TAVI and MitraClip)	Medicare Advantage and Dual Eligible Special Needs Plans Prior Authorization and Notification List, Pg 10 Original policy
33366	Patent foramen ovale (PFO) and atrial septal defect (ASD) closure Transcatheter valve surgeries (TMVR, TAVR/TAVI and MitraClip)	Medicare Advantage and Dual Eligible Special Needs Plans Prior Authorization and Notification List, Pg 10 Original policy
33418	Patent foramen ovale (PFO) and atrial septal defect (ASD) closure Transcatheter valve surgeries (TMVR, TAVR/TAVI and MitraClip)	Medicare Advantage and Dual Eligible Special Needs Plans Prior Authorization and Notification List, Pg 10 Original policy
0345T	Patent foramen ovale (PFO) and atrial septal defect (ASD) closure Transcatheter valve surgeries (TMVR, TAVR/TAVI and MitraClip)	Medicare Advantage and Dual Eligible Special Needs Plans Prior Authorization and Notification List, Pg 10 Original policy
0805T	Patent foramen ovale (PFO) and atrial septal defect (ASD) closure Transcatheter valve surgeries (TMVR, TAVR/TAVI and MitraClip)	Medicare Advantage and Dual Eligible Special Needs Plans Prior Authorization and Notification List, Pg 10 Original policy
0806T	Patent foramen ovale (PFO) and atrial septal defect (ASD) closure Transcatheter valve surgeries (TMVR, TAVR/TAVI and MitraClip)	Medicare Advantage and Dual Eligible Special Needs Plans Prior Authorization and Notification List, Pg 10 Original policy
38225	Cellular (including chimeric antigen receptor T-cell therapy (CAR T)), genetic, tissue and transplant therapies	Medicare Advantage and Dual Eligible Special Needs Plans Prior Authorization and Notification List, Pg 10 Original policy
38226	Cellular (including chimeric antigen receptor T-cell therapy (CAR T)), genetic, tissue and transplant therapies	Medicare Advantage and Dual Eligible Special Needs Plans Prior Authorization and Notification List, Pg 10 Original policy
38227	Cellular (including chimeric antigen receptor T-cell therapy (CAR T)), genetic, tissue and transplant therapies	Medicare Advantage and Dual Eligible Special Needs Plans Prior Authorization and Notification List, Pg 10 Original policy
38228	Cellular (including chimeric antigen receptor T-cell therapy (CAR T)), genetic, tissue and transplant therapies	Medicare Advantage and Dual Eligible Special Needs Plans Prior Authorization and Notification List, Pg 10 Original policy
38999	Cellular (including chimeric antigen receptor T-cell therapy (CAR T)), genetic, tissue and transplant therapies	Medicare Advantage and Dual Eligible Special Needs Plans Prior Authorization and Notification List, Pg 10 Original policy
60699	Cellular (including chimeric antigen receptor T-cell therapy (CAR T)), genetic, tissue and transplant therapies	Medicare Advantage and Dual Eligible Special Needs Plans Prior Authorization and Notification List, Pg 10 Original policy
C9399	Cellular (including chimeric antigen receptor T-cell therapy (CAR T)), genetic, tissue and transplant therapies	Medicare Advantage and Dual Eligible Special Needs Plans Prior Authorization and Notification List, Pg 10 Original policy
J3386*	Cellular (including chimeric antigen receptor T-cell therapy (CAR T)), genetic, tissue and transplant therapies	Medicare Advantage and Dual Eligible Special Needs Plans Prior Authorization and Notification List, Pg 10 Original policy
J3387	Cellular (including chimeric antigen receptor T-cell therapy (CAR T)), genetic, tissue and transplant therapies	Medicare Advantage and Dual Eligible Special Needs Plans Prior Authorization and Notification List, Pg 10 Original policy
J3389	Cellular (including chimeric antigen receptor T-cell therapy (CAR T)), genetic, tissue and transplant therapies	Medicare Advantage and Dual Eligible Special Needs Plans Prior Authorization and Notification List, Pg 10 Original policy
J3391	Cellular (including chimeric antigen receptor T-cell therapy (CAR T)), genetic, tissue and transplant therapies	Medicare Advantage and Dual Eligible Special Needs Plans Prior Authorization and Notification List, Pg 10 Original policy
J3392	Cellular (including chimeric antigen receptor T-cell therapy (CAR T)), genetic, tissue and transplant therapies	Medicare Advantage and Dual Eligible Special Needs Plans Prior Authorization and Notification List, Pg 10 Original policy
J3393	Cellular (including chimeric antigen receptor T-cell therapy (CAR T)), genetic, tissue and transplant therapies	Medicare Advantage and Dual Eligible Special Needs Plans Prior Authorization and Notification List, Pg 10 Original policy
J3394	Cellular (including chimeric antigen receptor T-cell therapy (CAR T)), genetic, tissue and transplant therapies	Medicare Advantage and Dual Eligible Special Needs Plans Prior Authorization and Notification List, Pg 10 Original policy
J3402*	Cellular (including chimeric antigen receptor T-cell therapy (CAR T)), genetic, tissue and transplant therapies	Medicare Advantage and Dual Eligible Special Needs Plans Prior Authorization and Notification List, Pg 10 Original policy
J3490	Cellular (including chimeric antigen receptor T-cell therapy (CAR T)), genetic, tissue and transplant therapies	Medicare Advantage and Dual Eligible Special Needs Plans Prior Authorization and Notification List, Pg 10 Original policy
J3590	Cellular (including chimeric antigen receptor T-cell therapy (CAR T)), genetic, tissue and transplant therapies	Medicare Advantage and Dual Eligible Special Needs Plans Prior Authorization and Notification List, Pg 10 Original policy
J9999	Cellular (including chimeric antigen receptor T-cell therapy (CAR T)), genetic, tissue and transplant therapies	Medicare Advantage and Dual Eligible Special Needs Plans Prior Authorization and Notification List, Pg 10 Original policy
Q2041	Cellular (including chimeric antigen receptor T-cell therapy (CAR T)), genetic, tissue and transplant therapies	Medicare Advantage and Dual Eligible Special Needs Plans Prior Authorization and Notification List, Pg 10 Original policy
Q2042	Cellular (including chimeric antigen receptor T-cell therapy (CAR T)), genetic, tissue and transplant therapies	Medicare Advantage and Dual Eligible Special Needs Plans Prior Authorization and Notification List, Pg 10 Original policy
Q2053	Cellular (including chimeric antigen receptor T-cell therapy (CAR T)), genetic, tissue and transplant therapies	Medicare Advantage and Dual Eligible Special Needs Plans Prior Authorization and Notification List, Pg 10 Original policy
Q2054	Cellular (including chimeric antigen receptor T-cell therapy (CAR T)), genetic, tissue and transplant therapies	Medicare Advantage and Dual Eligible Special Needs Plans Prior Authorization and Notification List, Pg 10 Original policy
Q2055	Cellular (including chimeric antigen receptor T-cell therapy (CAR T)), genetic, tissue and transplant therapies	Medicare Advantage and Dual Eligible Special Needs Plans Prior Authorization and Notification List, Pg 10 Original policy
Q2056	Cellular (including chimeric antigen receptor T-cell therapy (CAR T)), genetic, tissue and transplant therapies	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

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.