Humana prior authorization, page 8

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
72127	Computed tomography (CT) scan	Medicare Advantage and Dual Eligible Special Needs Plans Prior Authorization and Notification List, Pg 13 Original policy
72130	Computed tomography (CT) scan	Medicare Advantage and Dual Eligible Special Needs Plans Prior Authorization and Notification List, Pg 13 Original policy
72132	Computed tomography (CT) scan	Medicare Advantage and Dual Eligible Special Needs Plans Prior Authorization and Notification List, Pg 13 Original policy
72133	Computed tomography (CT) scan	Medicare Advantage and Dual Eligible Special Needs Plans Prior Authorization and Notification List, Pg 13 Original policy
72191	Computed tomography (CT) scan	Medicare Advantage and Dual Eligible Special Needs Plans Prior Authorization and Notification List, Pg 13 Original policy
72193	account: ources	Medicare Advantage and Dual Eligible Special Needs Plans Prior Authorization and Notification List, Pg 13 Original policy
72194	account: ources	Medicare Advantage and Dual Eligible Special Needs Plans Prior Authorization and Notification List, Pg 13 Original policy
73206	account: ources	Medicare Advantage and Dual Eligible Special Needs Plans Prior Authorization and Notification List, Pg 13 Original policy
73706	account: ources	Medicare Advantage and Dual Eligible Special Needs Plans Prior Authorization and Notification List, Pg 13 Original policy
74160	account: ources	Medicare Advantage and Dual Eligible Special Needs Plans Prior Authorization and Notification List, Pg 13 Original policy
74170	account: ources	Medicare Advantage and Dual Eligible Special Needs Plans Prior Authorization and Notification List, Pg 13 Original policy
74174	account: ources	Medicare Advantage and Dual Eligible Special Needs Plans Prior Authorization and Notification List, Pg 13 Original policy
74175	account: ources	Medicare Advantage and Dual Eligible Special Needs Plans Prior Authorization and Notification List, Pg 13 Original policy
74177	account: ources	Medicare Advantage and Dual Eligible Special Needs Plans Prior Authorization and Notification List, Pg 13 Original policy
74178	account: ources	Medicare Advantage and Dual Eligible Special Needs Plans Prior Authorization and Notification List, Pg 13 Original policy
75572	account: ources	Medicare Advantage and Dual Eligible Special Needs Plans Prior Authorization and Notification List, Pg 13 Original policy
75573	account: ources	Medicare Advantage and Dual Eligible Special Needs Plans Prior Authorization and Notification List, Pg 13 Original policy
75574	account: ources	Medicare Advantage and Dual Eligible Special Needs Plans Prior Authorization and Notification List, Pg 13 Original policy
75635	account: ources	Medicare Advantage and Dual Eligible Special Needs Plans Prior Authorization and Notification List, Pg 13 Original policy
93600	Electrophysiology Study (EPS) or EPS with 3D mapping	Medicare Advantage and Dual Eligible Special Needs Plans Prior Authorization and Notification List, Pg 13 Original policy
93602	Electrophysiology Study (EPS) or EPS with 3D mapping	Medicare Advantage and Dual Eligible Special Needs Plans Prior Authorization and Notification List, Pg 13 Original policy
93603	Electrophysiology Study (EPS) or EPS with 3D mapping	Medicare Advantage and Dual Eligible Special Needs Plans Prior Authorization and Notification List, Pg 13 Original policy
93610	Electrophysiology Study (EPS) or EPS with 3D mapping	Medicare Advantage and Dual Eligible Special Needs Plans Prior Authorization and Notification List, Pg 13 Original policy
93612	Electrophysiology Study (EPS) or EPS with 3D mapping	Medicare Advantage and Dual Eligible Special Needs Plans Prior Authorization and Notification List, Pg 13 Original policy
93618	Electrophysiology Study (EPS) or EPS with 3D mapping	Medicare Advantage and Dual Eligible Special Needs Plans Prior Authorization and Notification List, Pg 13 Original policy
93619	Electrophysiology Study (EPS) or EPS with 3D mapping	Medicare Advantage and Dual Eligible Special Needs Plans Prior Authorization and Notification List, Pg 13 Original policy
93620	Electrophysiology Study (EPS) or EPS with 3D mapping	Medicare Advantage and Dual Eligible Special Needs Plans Prior Authorization and Notification List, Pg 13 Original policy
93631	Electrophysiology Study (EPS) or EPS with 3D mapping	Medicare Advantage and Dual Eligible Special Needs Plans Prior Authorization and Notification List, Pg 13 Original policy
93640	Electrophysiology Study (EPS) or EPS with 3D mapping	Medicare Advantage and Dual Eligible Special Needs Plans Prior Authorization and Notification List, Pg 13 Original policy
93641	Electrophysiology Study (EPS) or EPS with 3D mapping	Medicare Advantage and Dual Eligible Special Needs Plans Prior Authorization and Notification List, Pg 13 Original policy
93642	Electrophysiology Study (EPS) or EPS with 3D mapping	Medicare Advantage and Dual Eligible Special Needs Plans Prior Authorization and Notification List, Pg 13 Original policy
93644	Electrophysiology Study (EPS) or EPS with 3D mapping	Medicare Advantage and Dual Eligible Special Needs Plans Prior Authorization and Notification List, Pg 13 Original policy
0577T	Electrophysiology Study (EPS) or EPS with 3D mapping	Medicare Advantage and Dual Eligible Special Needs Plans Prior Authorization and Notification List, Pg 13 Original policy
70544	Magnetic resonance angiography (MRA)	Medicare Advantage and Dual Eligible Special Needs Plans Prior Authorization and Notification List, Pg 13 Original policy
70545	Magnetic resonance angiography (MRA)	Medicare Advantage and Dual Eligible Special Needs Plans Prior Authorization and Notification List, Pg 13 Original policy
70546	Magnetic resonance angiography (MRA)	Medicare Advantage and Dual Eligible Special Needs Plans Prior Authorization and Notification List, Pg 13 Original policy
70547	Magnetic resonance angiography (MRA)	Medicare Advantage and Dual Eligible Special Needs Plans Prior Authorization and Notification List, Pg 13 Original policy
70548	Magnetic resonance angiography (MRA)	Medicare Advantage and Dual Eligible Special Needs Plans Prior Authorization and Notification List, Pg 13 Original policy
70549	Magnetic resonance angiography (MRA)	Medicare Advantage and Dual Eligible Special Needs Plans Prior Authorization and Notification List, Pg 13 Original policy
71555	Magnetic resonance angiography (MRA)	Medicare Advantage and Dual Eligible Special Needs Plans Prior Authorization and Notification List, Pg 13 Original policy
72159	Magnetic resonance angiography (MRA)	Medicare Advantage and Dual Eligible Special Needs Plans Prior Authorization and Notification List, Pg 13 Original policy
72198	Magnetic resonance angiography (MRA)	Medicare Advantage and Dual Eligible Special Needs Plans Prior Authorization and Notification List, Pg 13 Original policy
73225	Magnetic resonance angiography (MRA)	Medicare Advantage and Dual Eligible Special Needs Plans Prior Authorization and Notification List, Pg 13 Original policy
73725	Magnetic resonance angiography (MRA)	Medicare Advantage and Dual Eligible Special Needs Plans Prior Authorization and Notification List, Pg 13 Original policy
74185	Magnetic resonance angiography (MRA)	Medicare Advantage and Dual Eligible Special Needs Plans Prior Authorization and Notification List, Pg 13 Original policy
C8900	Magnetic resonance angiography (MRA)	Medicare Advantage and Dual Eligible Special Needs Plans Prior Authorization and Notification List, Pg 13 Original policy
C8901	Magnetic resonance angiography (MRA)	Medicare Advantage and Dual Eligible Special Needs Plans Prior Authorization and Notification List, Pg 13 Original policy
C8902	Magnetic resonance angiography (MRA)	Medicare Advantage and Dual Eligible Special Needs Plans Prior Authorization and Notification List, Pg 13 Original policy
C8909	Magnetic resonance angiography (MRA)	Medicare Advantage and Dual Eligible Special Needs Plans Prior Authorization and Notification List, Pg 13 Original policy
C8910	Magnetic resonance angiography (MRA)	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.