Medicare AdvantageCoverageMedium impact
Lymphedema - Diagnosis and Treatment - Medicare Advantage (Revised)
Humana·Physical Therapy, Occupational Therapy, Oncology +1 more·Medicare Advantage
Effective date
Jul 1, 2026
We identified it
Oct 15, 2026
Summary
This is a historical discovery of Humana's revised Medicare Advantage lymphedema diagnosis and treatment policy, effective 07/01/2026. The policy establishes medical necessity criteria for bioimpedance spectroscopy (BIS) and lymphedema treatment modalities including compression devices, manual lymph drainage, and pneumatic compression pumps. Since the effective date (07/01/2026) has already passed relative to the analysis date (10/15/2026), the billing team should verify current applicability and confirm implementation of these coverage criteria.
Action Required
Already effective as of 07/01/2026: Verify whether the practice has implemented Humana Medicare Advantage coverage criteria for bioimpedance spectroscopy (CPT 93702) and associated lymphedema treatment services. Confirm current applicability by reviewing the policy number HUM-1154-009 with Humana directly. If not yet implemented, billing team should update prior authorization workflows and medical necessity documentation requirements to align with the stated criteria: BIS may be performed up to 4 times per year for the first year following axillary or pelvic lymph node removal, damage, or irradiation when the individual has developed lymphedema or is at risk due to BMI ≥30 or postoperative infection. Update claim submission processes to include required clinical documentation supporting medical necessity for all BIS requests submitted to this Humana plan.