Humana Medical Policy Updates – December 2023

Click here to view the Humana Medical Policy Updates Updates »

December 2023 Humana Medical Policy Updates:

• Ablation Techniques and Extracorporeal Shock Wave Therapy for Musculoskeletal Indications and Soft Tissue Wounds – Medicare Advantage
• Achalasia and Gastroesophageal Reflux Disease Treatments – Medicare Advantage
• Airway Clearance Devices – Medicare Advantage
• Allograft Transplantation of the Knee – Medicare Advantage
• Ambulatory Cardiac Monitoring Devices – Medicare Advantage
• Artificial Intervertebral Disc Replacement – Medicare Advantage
• Athletic Pubalgia Surgery – Medicare Advantage
• Autism Spectrum Disorders Diagnosis and Treatments – Medicare Advantage
• Autologous and Allogeneic Bone Marrow Transplants/Peripheral Stem Cell Transplants/Umbilical Cord Blood Transplants – Medicare Advantage
• Balloon Dilation (Eustachian Tube and Sinus), Functional Endoscopic Sinus Surgery and RhinAer – Medicare Advantage
• Bariatric Surgery
• Bariatric Surgery – Medicare Advantage
• Benign Prostatic Hyperplasia Treatments – Medicare Advantage
• Blepharoplasty, Blepharoptosis Repair, and Brow Lift – Medicare Advantage
• Blepharoplasty, Blepharoptosis Repair, and Brow Lift – Medicare Advantage
• Bone Graft Substitutes – Medicare Advantage
• Brachytherapy
• Brachytherapy – Medicare Advantage
• Breast Imaging – Medicare Advantage
• Breast Reconstruction – Medicare Advantage
• Bronchial Thermoplasty – Medicare Advantage
• Bunion and Bunionette Surgical Treatments – Medicare Advantage
• Capsule Endoscopy – Medicare Advantage
• Cardiac Catheterization – Medicare Advantage
• Cardiac Electrophysiological Studies and Cardiac Catheter Ablation – Medicare Advantage
• Cardiac Pacemakers – Medicare Advantage
• Cardiac Rehabilitation
• Cardiac Single-Photon Emission Computed Tomography – Medicare Advantage
• Cardiovascular Disease Risk Testing
• Cardioverter Defibrillators/Cardiac Resynchronization Therapy – Medicare Advantage
• Carotid Revascularization
• Carotid Revascularization – Medicare Advantage
• Carpal Tunnel Syndrome Surgical Treatments – Medicare Advantage
• Code Compendium (Miscellaneous)
• Code Compendium (Musculoskeletal and Neurologic) – Medicare Advantage
• Code Compendium (Wound Care) – Medicare Advantage
• Cold and Heat Therapy Devices – Medicare Advantage
• Colorectal Cancer Screening and Surveillance – Medicare Advantage
• Comparative Genomic Hybridization/Chromosomal Microarray
• Complementary and Alternative Medicine – Medicare Advantage
• Comprehensive Genomic Profiling and Genetic Testing for Solid Tumors – Medicare Advantage
• Comprehensive Genomic Profiling and Genetic Testing for Solid Tumors – Medicare Advantage)
• Coronary CT Angiography, Fractional Flow Reserve with CT, Calcium Scoring – Medicare Advantage
• Cosmetic and Reconstructive Surgery – Medicare Advantage
• Cosmetic and Reconstructive Surgery – Medicare Advantage
• Cranial Electrical Stimulation – Medicare Advantage
• Cryoablation – Medicare Advantage
• Deep Brain Stimulation and Cortical Stimulation – Medicare Advantage
• Diagnostic Esophagogastroduodenoscopy or Esophagoscopy – Medicare Advantage
• Diagnostic Esophagogastroduodenoscopy or Esophagoscopy (59 years of age or younger) – Medicare Advantage
• Drug Testing – Medicare Advantage
• Durable Medical Equipment
• Dynamic Spinal Stabilization Devices – Medicare Advantage
• Dynamic Spinal Stabilization Devices – Medicare Advantage
• Elective Aorta and Iliac Artery Aneurysm Repair
• Elective Aorta and Iliac Artery Aneurysm Repair – Medicare Advantage
• Electric Tumor Treatment Fields – Medicare Advantage
• Electrical Stimulators – Diaphragmatic/Phrenic Nerve, Functional and Neuromuscular – Medicare Advantage
• Electrothermal Intradiscal Therapies – Medicare Advantage
• Endobronchial Valves for Emphysema – Medicare Advantage
• Erectile Dysfunction and Peyronie’s Disease Treatments – Medicare Advantage
• Extraosseous Subtalar Joint Implantation and Subtalar Arthroereisis – Medicare Advantage
• Fecal Incontinence Evaluation and Treatments – Medicare Advantage
• Fusion Imaging for Cancer Indications – Medicare Advantage
• Fusion Imaging for Noncancer Indications – Medicare Advantage
• Gastric Pacing/Gastric Electrical Stimulation
• Gastric Pacing/Gastric Electrical Stimulation – Medicare Advantage
• Gender Affirmation Surgery – Medicare Advantage
• Gene Expression Profiling for Cancer Indications – Medicare Advantage
• Gene Expression Profiling for Idiopathic Pulmonary Fibrosis- Medicare Advantage
• Gene Expression Profiling for Noncancer Indications – Medicare Advantage
• Genetic and Biomarker Testing for Alzheimer Disease – Medicare Advantage
• Genetic and Coagulation Testing for Noncancer Blood Disorders – Medicare Advantage
• Genetic Testing – Medicare Advantage
• Genetic Testing and Liquid Biopsy for Prostate Cancer
• Genetic Testing for Cardiac Conditions – Medicare Advantage
• Genetic Testing for Diagnosis of Inherited Conditions – Medicare Advantage
• Genetic Testing for Hematologic Malignancies and Suspected Myeloid Disorders – Medicare Advantage
• Genetic Testing for Hematologic Malignancies and Suspected Myeloid Disorders – Medicare Advantage
• Genetic Testing for Hereditary Ataxias – Medicare Advantage
• Genetic Testing for Hereditary Breast, Ovarian, Pancreatic and Prostate Cancer – Medicare Advantage
• Genetic Testing for Hereditary Cancer – Medicare Advantage
• Genetic Testing for Hereditary Colorectal and Uterine Cancer – Medicare Advantage
• Glaucoma Surgical Treatments – Medicare Advantage
• Hammertoe Surgical Treatments – Medicare Advantage
• Headache and Occipital Neuralgia Treatments – Medicare Advantage
• Hip Arthroplasty
• Hip Arthroplasty – Medicare Advantage
• Hip, Knee and Shoulder Arthroscopic Surgeries – Medicare Advantage
• Hospital Services (Long Term Care Hospitals (LTCH) – Medicare Advantage
• Hospital Services (Long Term Care Hospitals (LTCH), Observation) – Medicare Advantage
• Hyperbaric Oxygen Therapy, Topical Oxygen Therapy – Medicare Advantage
• Hyperthermia for Treatment of Cancer – Medicare Advantage
• Hyperthermia Treatment for Cancer (Local, Regional and Whole Body)
• Implantable and Non-Implantable Hearing Devices – Medicare Advantage
• Implantable Cardiac Devices for Hemodynamic Management – Medicare Advantage
• Implantable Infusion Pumps for Pain or Spasticity – Medicare Advantage
• Infertility Evaluation and Treatments – Medicare Advantage
• Inhaled Nitric Oxide
• Injections for Chronic Pain Conditions – Medicare Advantage
• Inpatient Hospital Services – Medicare Advantage
• Intensity Modulated Radiation Therapy – Medicare Advantage
• Interspinous Process Decompression Spacers – Medicare Advantage
• Intraoperative Neurological Monitoring – Medicare Advantage
• Knee Arthroplasty – Medicare Advantage
• Laparoscopic Hiatal Hernia Repair – Medicare Advantage
• Left Atrial Appendage and Cardiac Structural Defect Closure for Stroke Prevention – Medicare Advantage
• Liquid Biopsy – Medicare Advantage
• Low Level Laser Therapy and High Power Laser Therapy – Medicare Advantage
• Lung Cancer Screening
• Lymphedema – Diagnosis and Treatment – Medicare Advantage
• Lymphedema – Diagnosis and Treatments – Medicare Advantage
• Measurable (Minimal) Residual Disease Testing – Medicare Advantage
• Microwave Thermotherapy – Medicare Advantage
• Molecular Biomarkers for Prostate Cancer Risk Stratification – Medicare Advantage
• Molecular Diagnostic Assays and Breath Testing for Transplant Rejection – Medicare Advantage
• Molecular Markers in Fine Needle Aspirates of Thyroid Nodules – Medicare Advantage
• Molecular Testing for HLA-B*27 for Ankylosing Spondylitis – Medicare Advantage
• Multianalyte Assays with Algorithmic Analyses for Cancer Indications – Medicare Advantage
• Multiplex Pathogen Identification Panels for Infectious Disease – Medicare Advantage
• Negative Pressure Wound Therapy – Medicare Advantage
• Noninvasive Home Ventilators – Medicare Advantage
• Noninvasive Tests for Hepatic Fibrosis – Medicare Advantage
• Obstructive Sleep Apnea and Other Sleep Related Breathing Disorders Nonsurgical Treatments – Medicare Advantage
• Obstructive Sleep Apnea and Other Sleep Related Breathing Disorders Surgical Treatments – Medicare Advantage
• Ocular Surface Disease Diagnosis and Treatments – Medicare Advantage
• Omisirge (omidubicel-onlv) – Medicare Advantage
• Orthognathic Surgery – Medicare Advantage
• Orthotics – Medicare Advantage
• Osteochondral and Subchondral Defects Surgery – Medicare Advantage
• Outpatient Rehabilitation (Physical Therapy, Occupational Therapy) – Medicare Advantage
• Panniculectomy, Abdominoplasty, Abdominal Contouring
• Percutaneous Coronary Intervention – Medicare Advantage
• Percutaneous Vertebroplasty, Kyphoplasty (Balloon-Assisted Vertebroplasty), Sacroplasty – Medicare Advantage
• Peripheral Artery Revascularization of the Lower Extremities – Medicare Advantage
• Peripheral Nerve Stimulators – Medicare Advantage
• Pharmacogenomic Testing – Medicare Advantage
• Pharmacogenomics – Cytochrome P450 Polymorphisms and VKORC1
• Pharmacogenomics and Companion Diagnostics
• Pharmacogenomics and Companion Diagnostics – Medicare Advantage
• Platelet Derived Growth Factors for Wound Healing – Medicare Advantage
• Preimplantation Genetic Testing
• Prosthetics
• Prosthetics – Medicare Advantage
• Proton Beam, Neutron Beam and Carbon Ion Radiation Therapy – Medicare Advantage
• Psychiatric Inpatient Hospitalization – Medicare Advantage
• Psychiatric Partial Hospital Program Services – Medicare Advantage
• Radiofrequency Tumor Ablation – Medicare Advantage
• Radiofrequency Tumor Ablation – Medicare Advantage
• Reduction Mammaplasty – Medicare Advantage
• Rheumatoid Arthritis: Biologic Markers and Pharmacologic Assessment – Medicare Advantage
• Serological and Fecal Testing for Inflammatory Bowel Disease – Medicare Advantage
• Shoulder Arthroplasty – Medicare Advantage
• Skin and Tissue Substitutes
• Skin and Tissue Substitutes – Medicare Advantage
• Skysona (elivaldogene autotemcel) – Medicare Advantage
• Solid Organ Transplants – Medicare Advantage
• Speech Generating Devices, Voice Prostheses
• Spinal Cord Stimulators – Medicare Advantage
• Spinal Decompression Surgery – Medicare Advantage
• Spinal Fusion Surgery – Medicare Advantage
• Substance Use Disorder Inpatient Services – Medicare Advantage
• Substance Use Disorder Partial Hospital Program Services – Medicare Advantage
• Temporomandibular Disorders – Medicare Advantage
• Thyroid Surgeries (Thyroidectomy & Lobectomy) – Medicare Advantage
• Thyroid Surgeries (Thyroidectomy and Lobectomy)
• Tinnitus Treatments – Medicare Advantage
• Transcatheter Peripheral Vascular Stents – Chest – Abdomen and Pelvis – Medicare Advantage
• Transcatheter Peripheral Vascular Stents – Chest, Abdomen and Pelvis – Medicare Advantage
• Transcatheter Valve Procedures – Medicare Advantage
• Transesophageal and Transthoracic Echocardiogram – Medicare Advantage
• Ultraviolet Light/Laser Therapy for Skin Conditions – Medicare Advantage
• Urinary Bladder Dysfunction – Medicare Advantage
• Urinary Bladder Dysfunction – Medicare Advantage
• Uterine Fibroid Surgical Treatments – Medicare Advantage
• Vagus Nerve Stimulation – Medicare Advantage
• Varicose Vein Treatments – Medicare Advantage
• Ventricular Assist Device, Total Artificial Heart – Medicare Advantage
• Videofluoroscopy, Dynamic MRI for Musculoskeletal Indications
• Videofluoroscopy, Dynamic MRI for Musculoskeletal Indications – Medicare Advantage
• Zynteglo (betibeglogene autotemcel) – Medicare Advantage

Click here to view the Humana Medical Policy Updates Updates »

Policy Alerts monitors Commercial and Medicare medical policies for changes. While medical Insurance carriers typically update medical policies annually, there are many reasons why they might review or update a policy. When reviews occur out of cycle they often go unnoticed. Policy Alerts keeps you updated when Payers make coverage changes to medical policies affecting your business.

Policy Alerts continuously monitors Commercial and Medicare Payer coverage information to keep you up-to-date on medical Insurance decisions in real-time. When changes occur, instant email alerts are delivered to your inbox. Clients have access to detailed coverage reports and medical policies through the interactive Policy Alerts Dashboard portal. Save time each month and keep focused on important Payer medical policy reviews and coverage decisions affecting your business!

Policy Alerts takes a client-focused hands-on approach and is constantly working to provide our customers with helpful insights and actionable analytics. We understand what our clients need and are dedicated to providing timely, accurate, and always up-to-date reports.

Health economic and reimbursement information provided by Policy Alerts is gathered from third-party sources and is subject to change without notice as a result of complex and frequently changing laws, regulations, rules and policies. All product and company names are trademarks™ or registered® trademarks of their respective holders. Use of them does not imply any affiliation with or endorsement by them. This information is presented for illustrative purposes only and does not constitute reimbursement or legal advice.

Humana

Humana