Claims processing edits

Indian male doctor using laptop computer at work in hospital.

We regularly update our claim payment system to better align with American Medical Association Current Procedural Terminology (CPT®), Healthcare Common Procedure Coding System (HCPCS) and International Classification of Diseases (ICD) code sets. We also align our system with other sources, such as, Centers for Medicare & Medicaid Services (CMS) guidelines, correct-coding initiatives, Humana policy, national benchmarks and industry standards.

We post notifications of upcoming changes to this page on the first Friday of each month.


These notifications inform providers that we plan to make a change to our code editing rules or claim payment processes. An individual notification may not describe previously implemented rules that still apply; the intent is to give notice of an upcoming change. Previously published notifications are available on this page for at least five years. A notification may be removed after five years, or sooner if the notice no longer applies.

Learn how to use the claims processing edits page.

Reminders and special announcements

Please review General reminders and special announcements for important information that applies to all code editing and claim submissions.

smartphone

General coding reminders and special announcements

Updates to code editing and payment processes

Submit code edit questions online

Additional resources