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*The external coding guidelines provided on this website are intended as general information only and are designed to communicate information about coding and documentation in an educational format. Humana is not providing or offering medical or legal advice, but rather, practical and useful information and tools in the
centers and worksite medical facilities. Over its more than 50 year history, Humana has consistently seized opportunities to meet changing customer needs. Today, the company is a leader in consumer engagement and providing guidance designed to lead to a better Plan experience throughout its diversified customer
Additional preventive care guidelines from specialty organizations. Humana periodically monitors compliance with nationally recognized clinical practice guidelines. Publication of these guidelines is not a promise or guarantee of coverage. Individuals should review their coverage to determine benefits.
Humana periodically monitors compliance with nationally recognized clinical practice guidelines to identify opportunities for improvement. Note: Humana publishes medical guidelines from a number of well-respected national sources. These guidelines may have some differences in recommendations.
While many guidelines are updated annually, others may not change for several years. Humana encourages health care professionals to look for these clinical practice guideline notifications in Humana's YourPractice. Medical and behavioral health clinical practice guidelines are available here.
Find suggested guidelines for preventive health screenings and checkups for adults to help stay healthy, prevent illness and detect disease early. when you visit a PCP in your health plan's network. For complete benefit details, refer to your plan's Individual Medical Policy. Healthy adult preventive healthcare guidelines
Clinical resources. Browse clinical and behavioral health guidelines, Medicaid materials, a list of services and procedures that may require medical records review and other resources.
Refer to Humana's guidelines when treating patients eligible for both Medicare and Medicaid. Find general eligibility and cost-sharing guidelines.
Behavioral healthcare guidelines from Humana Behavioral Health for diagnosing, managing or treating a clinical condition.
Humana's medical and pharmacy coverage policies are based on evidence published in peer-reviewed medical literature, technology assessments obtained from independent medical research organizations, evidence-based consensus statements and evidence-based guidelines from nationally recognized professional

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March 2018