The schedule of updates and notifications are as follows:
| Physician/Health Care Providers | Outpatient/Inpatient Facilities |
| Implementation Date | Date Posted to Web | Implementation Date | Date Posted to Web |
| January 26, 2013 | October 25, 2012 | January 26, 2013 | October 25, 2012 |
| April 13, 2013 | January 11, 2013 | April 13, 2013 | January 11, 2013 |
| June 22, 2013 | March 22, 2013 | June 22, 2013 | March 22, 2013 |
| September 14, 2013 | June 14, 2013 | September 14, 2013 | June 14, 2013 |
| November 9, 2013 | August 9, 2013 | November 9, 2013 | August 9, 2013 |
Download and Print
Code Edit and Policy Change Notifications
Posted below is a list of the most current notifications of changes, as well as a compiled list of updates that were posted previously for physicians/health care providers and for facility claims from November 2008 through today. (Please note: These are not all-inclusive lists of every policy and code edit that may be applied to claims by Humana.) Puerto Rico market versions of the notifications are in their original format in a separate table below.
The lists include a general category, a specific topic, a detailed statement of the policy or update, the products that are affected by the statement and the status of the policy or update (e.g., active, edit not implemented, delayed, etc.). The files list general reminders first, and then are sorted by the category, topic, the detailed statement and effective date. Updates may be viewed and/or downloaded and printed by selecting the appropriate link below. Keyword search is also available for specific topics, procedures or diagnoses from within the document to help locate information relevant to claims.
Current Update List:
- Physician/Health Care Providers All Markets (Excluding Puerto Rico) - effective 6/22/2013
- (257 KB) Download PDF
- English
- Inpatient/Outpatient Facilities All Markets (Excluding Puerto Rico) - effective 6/22/2013
- (257 KB) Download PDF
- English
Compiled Updates from 2008 to Current:
- Physician/Health Care Providers All Markets (Excluding Puerto Rico)
- (1.1 MB) Download PDF
- English
- Inpatient/Outpatient Facilities All Markets (Excluding Puerto Rico)
- (1.2 MB) Download PDF
- English
Additional information about code-editing changes is available via the "Code Editing Questions" application on the secure provider area of Humana.com/providers (registration required). Health care providers may follow these steps to submit questions:
- On Humana.com/providers, select the "Log In" button
- Log in using the fields under "Log In"
- On the "Claims Tools" tab, select "Code Editing Questions" under "Associated Links" to submit question(s)
In order to access the "Code Editing Questions" application, you must be registered on Humana's website. Health care providers may follow these instructions to register:
- On Humana.com/providers, select the "Register" button
- Select "Provider" on the "Please tell us who you are" screen to start the provider registration process
- Follow the instructions on the page to move through the application process
Once the registration process is complete, the health care provider will be able to access "Code Editing Questions" and submit questions on the secure provider website of Humana.com.
Puerto Rico Market (Spanish)
Current list of updates:
- Physician/Health Care Providers Puerto Rico Only - effective 6/22/2013
- (257 KB) Download PDF
- Spanish
- Inpatient/Outpatient Facilities Puerto Rico Only - effective 6/22/2013
- (257 KB) Download PDF
- Spanish
- Physician/Health Care Providers Puerto Rico only - effective 4/13/2013
- (253 KB) Download PDF
- Spanish
- Inpatient/Outpatient Facilities Puerto Rico only - effective 4/13/2013
- (326 KB) Download PDF
- Spanish
- Physician/Health Care Providers Puerto Rico only - effective 1/26/2013
- (253 KB) Download PDF
- Spanish
- Inpatient/Outpatient Facilities Puerto Rico only - effective 1/26/2013
- (326 KB) Download PDF
- Spanish
Prior Lists of updates (Physician/Health Care Providers):
- Physician/Health Care Providers Puerto Rico only - effective 4/14/2012
- (135.5 KB) Download PDF
- Spanish
- Inpatient/Outpatient Facilities Puerto Rico only - effective 4/24/2012
- (293 KB) Download PDF
- Spanish
- Puerto Rico only - effective 1/23/2012
- (323 KB) Download PDF
- Spanish
- Puerto Rico only - effective 11/5/2011
- (311 KB) Download PDF
- Spanish
- Puerto Rico only - effective 6/24/2011
- (76 KB) Download PDF
- Spanish
- Puerto Rico only - effective 4/1/2011
- (314 KB) Download PDF
- Spanish
- Puerto Rico only - effective 1/22/2011
- (268 KB) Download PDF
- Spanish
Prior Lists of updates (Inpatient/Outpatient Facilities):
- Puerto Rico only - effective 1/31/2012
- (186 KB) Download PDF
- Spanish
- Puerto Rico only - effective 11/29/2011
- (320 KB) Download PDF
- Spanish
- Puerto Rico only - effective 6/7/2011
- (330 KB) Download PDF
- Spanish
- Puerto Rico only - effective 11/30/2010
- (575 KB) Download PDF
- Spanish
Significant Edits
View a list of edits that affect at least 500 claims per year and differ from AMA CPT or CMS Correct Coding Initiative (CCI) coding guidelines.
- Significant Edits
- (20.2 KB) Download PDF
- English
Modifier 59 Edits
View a list of code combinations that Humana has determined are not appropriately reported together with a modifier 59 and which differ from AMA CPT coding guidelines.
- Modifier 59 Edits
- (17.9 KB) Download PDF
- English
