Medicare AdvantageCoverageMedium impact
Nuclear Imaging for Noncancer Indications - Medicare Advantage (Revised)
Humana·Nuclear Medicine, Radiology, Cardiology +1 more·Medicare Advantage
We identified it
Jul 2, 2026
Summary
This is a definitional policy update from Humana Medicare Advantage clarifying what constitutes nuclear imaging for noncancer indications. The policy defines nuclear imaging as a method of detecting radiation from radioactive tracers to produce diagnostic images, and specifies that it includes bone scans, gallium scans, positron emission tomography (PET), and fusion imaging. This appears to be foundational policy language rather than a coverage restriction change, but billing teams must verify coverage and prior authorization requirements for specific nuclear imaging procedures under this revised policy.
Action Required
By [EFFECTIVE DATE - TO BE DETERMINED FROM FULL POLICY]: Billing team must obtain the complete policy document (not summary only) to identify: (1) specific CPT codes affected (e.g., nuclear medicine codes 78000-78999 range), (2) prior authorization requirements, (3) medical necessity criteria for noncancer indications, and (4) any changes to coverage policies. Update billing system rules, prior authorization workflows, and provider documentation requirements accordingly. Contact Humana directly using the source URL to confirm effective date and obtain full policy text, as summary-only access may result in incomplete billing guidance. Failure to implement correct prior auth and billing procedures will result in claim denials.