MedicaidCoverageMedium impact
Spinal Decompression Surgery - MEDICAID - OKLAHOMA (New)
Humana·OK · Neurosurgery, Orthopedics, Pain Management·Medicaid
We identified it
Jul 23, 2026
Summary
Humana Medicaid Oklahoma has issued a new policy defining spinal decompression surgery coverage. This is a summary-only policy that outlines the general term and procedural scope (discectomy, laminectomy, laminotomy, foraminotomy, foraminectomy, facetectomy, spinal fusion, or combinations). The billing team must obtain the complete policy details to determine coverage criteria, prior authorization requirements, and specific billing guidance.
Action Required
IMMEDIATELY: Billing team must obtain the complete policy document from Humana Medicaid Oklahoma (not the summary-only version) by accessing the source URL or contacting Humana directly. Do not bill spinal decompression procedures until the full policy is reviewed. Identify the specific CPT codes for discectomy, laminectomy, laminotomy, foraminotomy, foraminectomy, facetectomy, and spinal fusion procedures, then update billing system rules, prior authorization requirements, and encounter documentation templates accordingly. Notify providers of any new authorization requirements or documentation mandates. Failure to comply may result in claim denials for Oklahoma Medicaid spinal decompression cases.