Medicare AdvantagePrior AuthMedium impact
Cinryze (C1 esterase inhibitor, human) (Revised)
Humana·KY, SC · Internal Medicine, Allergy & Immunology·Medicaid
We identified it
Jul 21, 2026
Summary
This is a revised Prior Authorization policy for Cinryze (C1 esterase inhibitor, human) affecting Medicare, Medicaid members in Kentucky and South Carolina. The specific changes from the previous version are not detailed in the summary-only source provided, requiring access to the full policy document for complete billing impact assessment.
Action Required
Immediately: Billing team must obtain and review the full Cinryze Prior Authorization policy from the source URL (https://dctm.humana.com/Mentor/Web/v.aspx?objectID=090009298a584812). Identify specific changes from the previous policy version and determine: (1) Updated prior auth requirements; (2) Any CPT/HCPCS codes affected; (3) Effective date of revisions. Update billing software and encounter forms by the stated effective date. Contact Humana directly if specific effective date is unclear. Claims submitted without compliance to revised requirements will be denied.