Medicare AdvantageCoverageHigh impact
Computed Tomography Angiography (CTA) of the Abdominal Aorta - Medicare Advantage (Revised)
Humana·Radiology, Vascular Surgery, Cardiology +1 more·Medicare Advantage
Effective date
Sep 1, 2026
We identified it
Aug 29, 2026
Summary
Humana Medicare Advantage has updated its coverage policy for CTA of the abdominal aorta (CPT 75635), effective September 1, 2026. The policy now specifies medical necessity criteria for Medicare Advantage members and explicitly excludes coverage for two adjunctive services: cardiac acoustic waveform recording (CPT 0716T) and quantitative CT tissue characterization for calcium scoring (CPT 0722T). Billing teams must ensure claims for these excluded codes are not submitted with abdominal aorta CTA procedures.
Action Required
Before September 1, 2026: Billing team must update claim submission protocols to prevent bundling or concurrent billing of CPT 0716T (cardiac acoustic waveform recording) and CPT 0722T (quantitative CT tissue characterization) with CPT 75635 (CTA abdominal aorta) for all Humana Medicare Advantage plans. Configure billing software to deny or block these code combinations. Update provider education materials to explain that these adjunctive services are not covered with abdominal aorta CTA due to lack of established clinical evidence. Providers and clinical staff should document medical necessity using the criteria outlined in the policy (suspected PAD, chronic limb-threatening ischemia, preprocedural imaging, postprocedural complications, or previous revascularization with symptoms). Failure to comply will result in claim denials and potential overpayment recovery.