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.

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.

Notifications for the Puerto Rico market

For notifications that impact the Puerto Rico market, select  display edits for the Puerto Rico market only.  These notifications are displayed in Spanish.

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

Submit a code edit question today

Additional resources

  • Claims processing edits
  • Code edit simulator
  • General coding reminders and special announcements
  • Claims payment policies
  • Making It Easier educational series