Payor
Humana
Rubrica tracks 29 sourced coverage rules across 29 CPT codes for Humana — covering interventional spine, pain management, ortho spine, and orthopedics. Plan type(s): commercial. National policy.
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Every Rubrica record cites a specific Humana policy document with last-reviewed date and (where available) verbatim source text. Aggregate coverage breakdown by procedure category is shown below; full payor-specific criteria require sign-in.
Coverage by category
Humana's coverage stance across procedure categories tracked in the Rubrica catalog.
| Category | Rules | Covered | Prior auth | Investigational |
|---|---|---|---|---|
| Spine Surgery | 6 | 6 | 6 | 0 |
| Other Procedure | 5 | 5 | 5 | 0 |
| Arthroplasty — Knee | 3 | 3 | 3 | 0 |
| Arthroscopy — Knee | 3 | 3 | 3 | 0 |
| Arthroplasty — Hip | 2 | 2 | 2 | 0 |
| Arthroscopy — Shoulder | 2 | 2 | 2 | 0 |
| Arthroplasty — Ankle | 1 | 1 | 1 | 0 |
| Arthroplasty — Shoulder | 1 | 1 | 1 | 0 |
| Arthroscopy — Hip | 1 | 1 | 1 | 0 |
| Decompression | 1 | 0 | 1 | 1 |
| Foot / Ankle | 1 | 1 | 1 | 0 |
| Hand / Upper Extremity | 1 | 1 | 1 | 0 |
Top tracked procedures
First 15 CPT codes in the Humana catalog. Sign in for verbatim criteria, source links, and the rest of the catalog.
| CPT | Procedure | Coverage |
|---|---|---|
22551 | ACDF — Anterior Cervical Discectomy and Fusion | Covered |
22558 | ALIF — Anterior Lumbar Interbody Fusion | Covered |
22612 | PLF — Posterior Lumbar Fusion (Posterolateral) | Covered |
22856 | Cervical Total Disc Replacement (TDR) — Single Level | Covered |
63030 | Laminotomy (Hemilaminectomy) with Disc Excision — Lumbar | Covered |
63047 | Laminectomy with Facetectomy and Foraminotomy — Lumbar | Covered |
27447 | Total Knee Arthroplasty (TKA) | Covered |
27130 | Total Hip Arthroplasty (THA) | Covered |
29827 | Arthroscopic Rotator Cuff Repair | Covered |
29888 | Arthroscopic ACL Reconstruction | Covered |
64721 | Open Carpal Tunnel Release | Covered |
27446 | Partial (Unicompartmental) Knee Arthroplasty | Covered |
23472 | Total Shoulder Arthroplasty (TSA / Reverse TSA) | Covered |
27487 | Revision TKA — Both Components | Covered |
27134 | Revision THA — Both Components | Covered |
29881 | Knee Arthroscopy with Meniscectomy (Medial OR Lateral) | Covered |
29882 | Knee Arthroscopy with Meniscus Repair (Medial OR Lateral) | Covered |
29826 | Shoulder Arthroscopy — Subacromial Decompression / Acromioplasty | Covered |
29914 | Hip Arthroscopy with Femoroplasty (FAI — Cam Lesion) | Covered |
28296 | Bunionectomy with Distal Metatarsal Osteotomy (Chevron / Mitchell) | Covered |
27702 | Total Ankle Arthroplasty (TAA) | Covered |
27486 | Revision Total Knee Arthroplasty — 1 component | Covered |
29848 | Endoscopic Carpal Tunnel Release | Covered |
22633 | Lumbar Transforaminal Interbody Fusion (TLIF) — single interspace, combined posterior + posterior interbody | Covered |
22842 | Posterior segmental instrumentation (3–6 vertebral segments) — add-on to fusion | Covered |
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