Back to dashboard
Medicare AdvantageCoverageMedium impact

Computed Tomography Angiography (CTA) of the Abdominal Aorta - Medicare Advantage (Revised)

Humana·Vascular Surgery, Radiology, Cardiology +1 more·Medicare Advantage
Effective date
May 4, 2026
We identified it
Jun 24, 2026
Days to comply

Summary

Humana Medicare Advantage has established new medical necessity criteria for CT angiography of the abdominal aorta (CPT 75635), defining specific clinical indications including suspected peripheral arterial disease, chronic limb-threatening ischemia, and pre/post-procedural imaging for revascularization. This policy provides coverage determination guidance for jurisdictions without existing local coverage determinations.

Action Required

Action needed
By May 4, 2026: Billing team must ensure proper documentation of medical necessity for CPT 75635 (CTA abdominal aorta) claims for Humana Medicare Advantage patients. Update pre-authorization workflows to verify patients meet specific criteria including suspected PAD with inconclusive testing, chronic limb-threatening ischemia symptoms, or pre/post-procedural imaging needs. Claims not meeting these criteria may be denied as not medically necessary.

Affected Billing Codes

75635