Updates to code editing and payment processes
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.
Reminders and special announcements
Please review
Notifications for the Puerto Rico market
For notifications that impact the Puerto Rico market, select
Submit code edit questions online
Physicians and healthcare providers can submit specific questions about code editing through Humana’s Code Editing Questions tool on the multipayer Availity Provider Portal
Additional resources
- Claims processing edits
Code edit simulator General coding reminders and special announcements Claims payment policies Making It Easier educational series