MedicaidCoverageMedium impact
Excessive Skin and Subcutaneous Tissue Removal - MEDICAID - KENTUCKY (New)
Humana·KY · Plastic Surgery, General Surgery·Medicaid
We identified it
Jul 21, 2026
Summary
Kentucky Medicaid has issued a new policy covering excessive skin and subcutaneous tissue removal procedures (body contouring after major weight loss). The policy defines covered procedures including lipectomy and skin removal on arms, buttocks, thighs, and torso, with goals of improving body contour and addressing skin infections. Billing teams must obtain and verify coverage details, prior authorization requirements, and applicable procedure codes from the complete policy document.
Action Required
Immediately: Billing team and providers must obtain the complete policy document from Humana Kentucky Medicaid (source: https://dctm.humana.com/Mentor/Web/v.aspx?objectID=090009298a584604) to extract specific CPT/HCPCS codes, effective date, prior authorization requirements, and medical necessity criteria. Add this policy to internal guidelines for plastic surgery and body contouring procedures. Contact Humana directly if CPT codes and effective date are not available in the summary. Until full policy details are confirmed, flag all excessive skin removal claims for Kentucky Medicaid beneficiaries for manual review to ensure compliance.