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Ablation (Cancer and Noncancer Indications) - MEDICAID - VIRGINIA (New)

Humana·VA · Oncology, Urology, Radiology +1 more·Medicaid
Effective date
Jun 17, 2026
We identified it
Jun 24, 2026
Days to comply

Summary

Humana Virginia Medicaid has established a new policy defining coverage criteria for cryoablation procedures for cancer and non-cancer conditions including bone tumors, kidney cysts/tumors, and liver tumors. The policy excludes coverage for transurethral ultrasound ablation (TULSA) for prostate conditions.

Action Required

Action needed
Before June 17, 2026: Billing team must update prior authorization protocols for Virginia Medicaid cryoablation procedures. Ensure documentation includes biopsy results for kidney tumors, tumor size measurements, and surgical candidacy assessments. Update billing system to flag denied codes 51721, 55881, and 55882 for prostate ablation procedures.

Affected Billing Codes

20983
47371
47381
47383
50250
50541
50542
50593
51721
55881
55882