Start free

PolicyChanges tracks payer policy changes for medical practices and tells you what to do before they take effect.

Create a free accountPolicy Monitoring is free. No card required.
← Back to list
HumanaMedicare Advantage · Coverage · Medicare Advantage · Orthopedics, Neurosurgery, Pain Management +2 moreHigh impact

Spinal Decompression Surgery - Medicare Advantage (Revised)

Effective date
Nov 2, 2026
Identified
Nov 3, 2026

Summary

Humana revised its Medicare Advantage Spinal Decompression Surgery coverage policy (HUM-1216-006), with an effective date of 11/02/2026 and an annual review dated 10/13/2026. The revision updates coverage criteria for discectomy, laminectomy/laminotomy/foraminectomy/foraminotomy, laminoplasty and corpectomy, adds coverage limitations excluding several percutaneous and laser discectomy techniques, annular closure, and AI/augmented-reality-guided decompression, and updates coding information including new 2026 codes 62330, 62331 and 63032.

Get alerts when payers change rules like this one

We check Humana and other payers every day and email you when a change matches your specialty and state.

Get Humana alertsPolicy Monitoring is free. No card required.

What to do

Action · 4 steps
01Effective 2026-11-02: Billing team should review the revised Humana Medicare Advantage Spinal Decompression Surgery policy and update charge entry and claim edits for the listed decompression codes so claims go out with documentation supporting the stated criteria (e.g., imaging correlation, 6 weeks of failed conservative treatment, or myelopathy findings).
02Stop scheduling or billing automated percutaneous lumbar discectomy (62287, C2614), laser discectomy, endoscopic disc decompression with radiofrequency ablation, annular closure (63032, C9757), and AI/augmented-reality-guided decompression for Humana Medicare Advantage members, and tell providers and front desk staff about these exclusions.
03Any percutaneous laminectomy-type procedure other than PILD/MILD (62330, 62331) under NCD 150.13 is listed as not medically reasonable and necessary; route such requests to providers before scheduling.
04Claims lacking the documentation the policy requires are likely to be denied, so attach or improve records before submission and watch for Humana's next notice.

Codes mentioned

6238063075630766307763078630016301563020630306303563040630426304363044630456304763048630506305163081630826308563086630876308863090630916310163102631036317063200632506325163252632656326663267632686327063271632726327363275632766327763278632806328163282632836328563286632876329063300633016330263303633046330563306633076330862287623306233163032C9757C2614228996499922100221012210222103630116301263003630166301763005630466305563056630576306463066631856319063191631726317363197

Original notice

Spinal Decompression Surgery - Medicare Advantage (Revised)
mcp.humana.com · Always check the source before changing claims.
View original ↗

Related changes

See all Humana changes →
Spinal Fusion and Stabilization Surgery - MEDICAID - KENTUCKY (New)MediumEffective Aug 5, 2026 · MedicaidSpinal Fusion and Stabilization Surgery - MEDICAID - FLORIDA (New)HighEffective Sep 16, 2026 · MedicaidSpinal Decompression Surgery - MEDICAID - SOUTH CAROLINA (Revised)MediumEffective Jul 22, 2026 · MedicaidSpinal Fusion and Stabilization Surgery - MEDICAID - VIRGINIA (Revised)HighEffective Apr 1, 2025 · MedicaidBrowse every Humana change in the policy list

Related policy hubs

Humana policiesOrthopedicsNeurosurgeryPain ManagementPM&R (Physical Medicine & Rehab)Physical TherapyCode 62380Code 63075Code 63076Code 63077Code 63078Code 63001Code 63015Code 63020Code 63030Code 63035Code 63040Code 63042Code 63043Code 63044Code 63045Code 63047Code 63048Code 63050Code 63051Code 63081Code 63082Code 63085Code 63086Code 63087Code 63088Code 63090Code 63091Code 63101Code 63102Code 63103Code 63170Code 63200Code 63250Code 63251Code 63252Code 63265Code 63266Code 63267Code 63268Code 63270Code 63271Code 63272Code 63273Code 63275Code 63276Code 63277Code 63278Code 63280Code 63281Code 63282Code 63283Code 63285Code 63286Code 63287Code 63290Code 63300Code 63301Code 63302Code 63303Code 63304Code 63305Code 63306Code 63307Code 63308Code 62287Code 62330Code 62331Code 63032Code C9757Code C2614Code 22899Code 64999Code 22100Code 22101Code 22102Code 22103Code 63011Code 63012Code 63003Code 63016Code 63017Code 63005Code 63046Code 63055Code 63056Code 63057Code 63064Code 63066Code 63185Code 63190Code 63191Code 63172Code 63173Code 63197

Summaries are AI-assisted. Always confirm against the original payer notice.

What is PolicyChanges

One workspace for payer rules, prior auth, coding and compliance

Medical practices use PolicyChanges to catch payer changes before they cause denials. Every change is summarized in plain English, with the codes involved, the date it takes effect and what to do.

Policy MonitoringPayer policy, prior auth and coding changes, filtered to your saved searchesOIG ScreeningStaff and vendors screened every month against OIG LEIE, SAM.gov and state Medicaid listsPrior Auth LookupKnow if a service needs prior authorization before you schedule itCredentialing TrackerLicenses, CAQH, Medicare revalidation and payer enrollments, with reminders before anything lapsesCompliance CenterKeep your HIPAA program documented and ready to show
Start freePolicy Monitoring is free. No card required.
Get alerts for changes like thisPolicy Monitoring is free. No card required.Create a free account