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HumanaMedicaid · Prior Auth · Medicaid · KY · Dermatology, Pediatrics, Plastic SurgeryHigh impact

Cutaneous Vascular Lesion Removal - MEDICAID - KENTUCKY (New)

Effective date
Sep 16, 2026
Identified
Sep 15, 2026

Summary

Humana Kentucky Medicaid has issued a new policy (effective 09/16/2026) establishing coverage criteria for cutaneous vascular lesion removal procedures. Coverage requires either failed conservative treatment or contraindicated conservative treatment, PLUS documentation of functional impairment, recurrent bleeding/painful nodules, or ulceration. Prior authorization is mandatory for all three CPT codes (17106, 17107, 17108). Members under age 21 receive EPSDT review.

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What to do

Action · 5 steps
01By 09/16/2026: Billing team must implement prior authorization requirement for CPT codes 17106, 17107, and 17108 in the billing system for all Humana Kentucky Medicaid claims (Healthy Horizons line).
02Update claim submission workflows to route these codes for mandatory pre-authorization.
03Clinical staff must document failed conservative treatment (e.g., triamcinolone, propranolol, timolol, systemic corticosteroids) or medical contraindication, PLUS one of the following: functional impairment affecting vital structures (ears, eyes, larynx, mouth, nose) or function (breathing, eating, hearing, speaking, swallowing); recurrent bleeding/painful nodules on extremities/trunk; or ulceration.
04Update provider encounter templates and clinical documentation requirements to ensure all three elements are captured.
05For members under 21, flag for EPSDT medical necessity review.
If missed: Failure to obtain prior authorization will result in claim denials.

Codes mentioned

171061710717108

Original notice

Cutaneous Vascular Lesion Removal - MEDICAID - KENTUCKY (New)
mcp.humana.com · Always check the source before changing claims.
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Related changes

See all Humana changes →
Cutaneous Vascular Lesion Removal - MEDICAID - KENTUCKY (New)MediumEffective Sep 16, 2026 · MedicaidCosmetic and Reconstructive Surgery - Medicare Advantage (Revised)HighEffective Oct 1, 2026 · Medicare AdvantageCosmetic and Reconstructive Surgery - Medicare Advantage (Revised)HighEffective Mar 2, 2026 · Medicare AdvantageCutaneous Vascular Lesion Removal - MEDICAID - INDIANA (New)MediumEffective Jan 30, 2026 · MedicaidBrowse every Humana change in the policy list

Related policy hubs

Humana policiesKY policy changesDermatologyPediatricsPlastic SurgeryCode 17106Code 17107Code 17108

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