Humana prior authorization, page 7

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
Q2057	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
Q2058	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
XW0338A	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
XW033C7	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
XW033G7	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
20560	Chiropractic and acupuncture therapy	Medicare Advantage and Dual Eligible Special Needs Plans Prior Authorization and Notification List, Pg 11 Original policy
20561	Chiropractic and acupuncture therapy	Medicare Advantage and Dual Eligible Special Needs Plans Prior Authorization and Notification List, Pg 11 Original policy
97810	Chiropractic and acupuncture therapy	Medicare Advantage and Dual Eligible Special Needs Plans Prior Authorization and Notification List, Pg 11 Original policy
97811	Chiropractic and acupuncture therapy	Medicare Advantage and Dual Eligible Special Needs Plans Prior Authorization and Notification List, Pg 11 Original policy
97813	Chiropractic and acupuncture therapy	Medicare Advantage and Dual Eligible Special Needs Plans Prior Authorization and Notification List, Pg 11 Original policy
97814	Chiropractic and acupuncture therapy	Medicare Advantage and Dual Eligible Special Needs Plans Prior Authorization and Notification List, Pg 11 Original policy
98940	Chiropractic and acupuncture therapy	Medicare Advantage and Dual Eligible Special Needs Plans Prior Authorization and Notification List, Pg 11 Original policy
98941	Chiropractic and acupuncture therapy	Medicare Advantage and Dual Eligible Special Needs Plans Prior Authorization and Notification List, Pg 11 Original policy
98942	Chiropractic and acupuncture therapy	Medicare Advantage and Dual Eligible Special Needs Plans Prior Authorization and Notification List, Pg 11 Original policy
98943	Chiropractic and acupuncture therapy	Medicare Advantage and Dual Eligible Special Needs Plans Prior Authorization and Notification List, Pg 11 Original policy
0783T	Cranial Electrotherapy Stimulation and Auricular Electrostimulation	Medicare Advantage and Dual Eligible Special Needs Plans Prior Authorization and Notification List, Pg 12 Original policy
E0721	Cranial Electrotherapy Stimulation and Auricular Electrostimulation	Medicare Advantage and Dual Eligible Special Needs Plans Prior Authorization and Notification List, Pg 12 Original policy
E0732	Cranial Electrotherapy Stimulation and Auricular Electrostimulation	Medicare Advantage and Dual Eligible Special Needs Plans Prior Authorization and Notification List, Pg 12 Original policy
17106	Cutaneous vascular lesion removal	Medicare Advantage and Dual Eligible Special Needs Plans Prior Authorization and Notification List, Pg 13 Original policy
17107	Cutaneous vascular lesion removal	Medicare Advantage and Dual Eligible Special Needs Plans Prior Authorization and Notification List, Pg 13 Original policy
17108	Cutaneous vascular lesion removal	Medicare Advantage and Dual Eligible Special Needs Plans Prior Authorization and Notification List, Pg 13 Original policy
29848	Decompression of peripheral nerve (i.e., carpal tunnel surgery)	Medicare Advantage and Dual Eligible Special Needs Plans Prior Authorization and Notification List, Pg 13 Original policy
64721	Decompression of peripheral nerve (i.e., carpal tunnel surgery)	Medicare Advantage and Dual Eligible Special Needs Plans Prior Authorization and Notification List, Pg 13 Original policy
64728	Decompression of peripheral nerve (i.e., carpal tunnel surgery)	Medicare Advantage and Dual Eligible Special Needs Plans Prior Authorization and Notification List, Pg 13 Original policy
70460	Diagnostic/cardiac imaging	Medicare Advantage and Dual Eligible Special Needs Plans Prior Authorization and Notification List, Pg 13 Original policy
70470	Diagnostic/cardiac imaging	Medicare Advantage and Dual Eligible Special Needs Plans Prior Authorization and Notification List, Pg 13 Original policy
70471	Diagnostic/cardiac imaging	Medicare Advantage and Dual Eligible Special Needs Plans Prior Authorization and Notification List, Pg 13 Original policy
70481	Computed tomography (CT) scan	Medicare Advantage and Dual Eligible Special Needs Plans Prior Authorization and Notification List, Pg 13 Original policy
70482	Computed tomography (CT) scan	Medicare Advantage and Dual Eligible Special Needs Plans Prior Authorization and Notification List, Pg 13 Original policy
70487	Computed tomography (CT) scan	Medicare Advantage and Dual Eligible Special Needs Plans Prior Authorization and Notification List, Pg 13 Original policy
70488	Computed tomography (CT) scan	Medicare Advantage and Dual Eligible Special Needs Plans Prior Authorization and Notification List, Pg 13 Original policy
70491	Computed tomography (CT) scan	Medicare Advantage and Dual Eligible Special Needs Plans Prior Authorization and Notification List, Pg 13 Original policy
70492	Computed tomography (CT) scan	Medicare Advantage and Dual Eligible Special Needs Plans Prior Authorization and Notification List, Pg 13 Original policy
70496	Magnetic resonance imaging (MRI)	Medicare Advantage and Dual Eligible Special Needs Plans Prior Authorization and Notification List, Pg 13 Original policy
70498	Magnetic resonance imaging (MRI)	Medicare Advantage and Dual Eligible Special Needs Plans Prior Authorization and Notification List, Pg 13 Original policy
70540	Magnetic resonance imaging (MRI)	Medicare Advantage and Dual Eligible Special Needs Plans Prior Authorization and Notification List, Pg 13 Original policy
70542	Magnetic resonance imaging (MRI)	Medicare Advantage and Dual Eligible Special Needs Plans Prior Authorization and Notification List, Pg 13 Original policy
70551	Magnetic resonance imaging (MRI)	Medicare Advantage and Dual Eligible Special Needs Plans Prior Authorization and Notification List, Pg 13 Original policy
70552	Magnetic resonance imaging (MRI)	Medicare Advantage and Dual Eligible Special Needs Plans Prior Authorization and Notification List, Pg 13 Original policy
70553	Magnetic resonance imaging (MRI)	Medicare Advantage and Dual Eligible Special Needs Plans Prior Authorization and Notification List, Pg 13 Original policy
73218	Magnetic resonance imaging (MRI)	Medicare Advantage and Dual Eligible Special Needs Plans Prior Authorization and Notification List, Pg 13 Original policy
73219	Magnetic resonance imaging (MRI)	Medicare Advantage and Dual Eligible Special Needs Plans Prior Authorization and Notification List, Pg 13 Original policy
73220	Magnetic resonance imaging (MRI)	Medicare Advantage and Dual Eligible Special Needs Plans Prior Authorization and Notification List, Pg 13 Original policy
73718	Magnetic resonance imaging (MRI)	Medicare Advantage and Dual Eligible Special Needs Plans Prior Authorization and Notification List, Pg 13 Original policy
73719	Magnetic resonance imaging (MRI)	Medicare Advantage and Dual Eligible Special Needs Plans Prior Authorization and Notification List, Pg 13 Original policy
73720	Magnetic resonance imaging (MRI)	Medicare Advantage and Dual Eligible Special Needs Plans Prior Authorization and Notification List, Pg 13 Original policy
71260	Computed tomography (CT) scan	Medicare Advantage and Dual Eligible Special Needs Plans Prior Authorization and Notification List, Pg 13 Original policy
71270	Computed tomography (CT) scan	Medicare Advantage and Dual Eligible Special Needs Plans Prior Authorization and Notification List, Pg 13 Original policy
71275	Computed tomography (CT) scan	Medicare Advantage and Dual Eligible Special Needs Plans Prior Authorization and Notification List, Pg 13 Original policy
72126	Computed tomography (CT) scan	Medicare Advantage and Dual Eligible Special Needs Plans Prior Authorization and Notification List, Pg 13 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.