MedicaidCoverageHigh impact
Spinal Fusion and Stabilization Surgery - MEDICAID - INDIANA (New)
Humana·IN · Orthopedics, Neurosurgery, Pain Management·Medicaid
Effective date
Jun 17, 2026
We identified it
Jun 24, 2026
Summary
This is a new comprehensive Medicaid policy for Indiana covering spinal fusion and stabilization surgeries, including artificial disc replacement, corpectomy, kyphectomy, and sacroiliac joint fusion. The policy establishes specific coverage criteria and includes detailed procedure codes for various spinal surgical procedures effective June 17, 2026.
Action Required
Before June 17, 2026: Billing team must update prior authorization requirements for all spinal fusion procedures for Indiana Medicaid patients. Ensure documentation meets specific coverage criteria including diagnostic imaging confirmation and conservative treatment failure. Update encounter forms to include required clinical documentation for corpectomy, kyphectomy, artificial disc replacement, and sacroiliac joint fusion procedures. Claims without proper documentation will be denied.