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HumanaMedicare Advantage · Coverage · Medicare Advantage · Plastic Surgery, Dermatology, General Surgery +1 moreMedium impact

Cosmetic and Reconstructive Surgery - Medicare Advantage (Revised)

Effective date
Mar 2, 2026
Identified
Jun 24, 2026

Summary

This is a revised Medicare Advantage policy for cosmetic and reconstructive surgery that provides updated coverage criteria and billing guidance for various procedures including skin lesion removal, panniculectomy, rhinoplasty, and scar revision. The policy clarifies when reconstructive procedures are considered medically necessary and references applicable Local Coverage Determinations by jurisdiction.

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What to do

Action · 3 steps
01Before March 2, 2026: Billing team must review and update prior authorization requirements and coverage criteria for cosmetic and reconstructive surgery procedures based on applicable Local Coverage Determinations for your jurisdiction.
02Update billing system rules to ensure proper documentation of functional impairment for reconstructive procedures.
03Verify coverage criteria for specific procedures like panniculectomy, keloid removal, and rhinoplasty match the revised policy requirements.

Codes mentioned

17110114001140111402114031140411405114061710617108171071738011440114411144211443114441144511446209101583030400304103042030430304353045030460304623046817111

Original notice

Cosmetic and Reconstructive Surgery - Medicare Advantage (Revised)
mcp.humana.com · Always check the source before changing claims.
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Related changes

See all Humana changes →
Cosmetic and Reconstructive Surgery - Medicare Advantage (Revised)HighEffective Mar 2, 2026 · Medicare AdvantageCosmetic and Reconstructive Surgery - Medicare Advantage (Revised)HighEffective Oct 1, 2026 · Medicare AdvantageCutaneous Vascular Lesion Removal - MEDICAID - KENTUCKY (New)MediumEffective Sep 16, 2026 · MedicaidCutaneous Vascular Lesion Removal - MEDICAID - KENTUCKY (New)HighEffective Sep 16, 2026 · MedicaidBrowse every Humana change in the policy list

Related policy hubs

Humana policiesPlastic SurgeryDermatologyGeneral SurgeryENT (Ear, Nose & Throat)Code 17110Code 11400Code 11401Code 11402Code 11403Code 11404Code 11405Code 11406Code 17106Code 17108Code 17107Code 17380Code 11440Code 11441Code 11442Code 11443Code 11444Code 11445Code 11446Code 20910Code 15830Code 30400Code 30410Code 30420Code 30430Code 30435Code 30450Code 30460Code 30462Code 30468Code 17111

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