Rubrica

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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29
Sourced rules
29
CPT codes tracked
27
Covered (93%)
29
Prior auth required

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.

CategoryRulesCoveredPrior authInvestigational
Spine Surgery6660
Other Procedure5550
Arthroplasty — Knee3330
Arthroscopy — Knee3330
Arthroplasty — Hip2220
Arthroscopy — Shoulder2220
Arthroplasty — Ankle1110
Arthroplasty — Shoulder1110
Arthroscopy — Hip1110
Decompression1011
Foot / Ankle1110
Hand / Upper Extremity1110

Top tracked procedures

First 15 CPT codes in the Humana catalog. Sign in for verbatim criteria, source links, and the rest of the catalog.

CPTProcedureCoverage
22551ACDF — Anterior Cervical Discectomy and FusionCovered
22558ALIF — Anterior Lumbar Interbody FusionCovered
22612PLF — Posterior Lumbar Fusion (Posterolateral)Covered
22856Cervical Total Disc Replacement (TDR) — Single LevelCovered
63030Laminotomy (Hemilaminectomy) with Disc Excision — LumbarCovered
63047Laminectomy with Facetectomy and Foraminotomy — LumbarCovered
27447Total Knee Arthroplasty (TKA)Covered
27130Total Hip Arthroplasty (THA)Covered
29827Arthroscopic Rotator Cuff RepairCovered
29888Arthroscopic ACL ReconstructionCovered
64721Open Carpal Tunnel ReleaseCovered
27446Partial (Unicompartmental) Knee ArthroplastyCovered
23472Total Shoulder Arthroplasty (TSA / Reverse TSA)Covered
27487Revision TKA — Both ComponentsCovered
27134Revision THA — Both ComponentsCovered
29881Knee Arthroscopy with Meniscectomy (Medial OR Lateral)Covered
29882Knee Arthroscopy with Meniscus Repair (Medial OR Lateral)Covered
29826Shoulder Arthroscopy — Subacromial Decompression / AcromioplastyCovered
29914Hip Arthroscopy with Femoroplasty (FAI — Cam Lesion)Covered
28296Bunionectomy with Distal Metatarsal Osteotomy (Chevron / Mitchell)Covered
27702Total Ankle Arthroplasty (TAA)Covered
27486Revision Total Knee Arthroplasty — 1 componentCovered
29848Endoscopic Carpal Tunnel ReleaseCovered
22633Lumbar Transforaminal Interbody Fusion (TLIF) — single interspace, combined posterior + posterior interbodyCovered
22842Posterior segmental instrumentation (3–6 vertebral segments) — add-on to fusionCovered

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