Humana Total Shoulder Arthroplasty prior authorization requirements (2026)

What Humana generally requires to approve Total Shoulder Arthroplasty (CPT 23472), for Commercial plans. Yes. Humana generally requires prior authorization for Total Shoulder Arthroplasty (CPT 23472).

General reference compiled from public sources. This is not a coverage determination or medical advice. Always confirm current requirements with Humana before submitting.

Medical-necessity criteria Humana generally applies

(1) Severe glenohumeral arthritis on X-ray (OA, AVN, post-traumatic, cuff tear arthropathy); (2) Conservative care failure ≥3 months; (3) ASES <50 AND active forward elevation <120°; (4) Anatomic TSA: intact/reparable cuff on MRI; Reverse TSA: massive irreparable cuff tear with intact deltoid; (5) Bone stock assessment if significant glenoid wear

Diagnoses that commonly support medical necessity

ICD-10-CM diagnoses frequently associated with medical necessity for Total Shoulder Arthroplasty. Confirm the covered diagnosis list against the current Humana policy.

M19.011Primary osteoarthritis, right shoulderM19.012Primary osteoarthritis, left shoulderM19.019Primary osteoarthritis, unspecified shoulder

Commonly required documentation

  • True AP glenoid and axillary X-rays
  • MRI for cuff status
  • ASES and elevation ROM
  • conservative care records
  • surgeon evaluation with implant type

How to submit

Source

Collect ASES and active elevation measurement at surgical visit. Medicare Advantage: include post-op rehab plan in submission.

Frequently asked questions

Does Humana require prior authorization for Total Shoulder Arthroplasty?

Yes. Humana generally requires prior authorization for Total Shoulder Arthroplasty (CPT 23472).

What does Humana require to approve Total Shoulder Arthroplasty?

(1) Severe glenohumeral arthritis on X-ray (OA, AVN, post-traumatic, cuff tear arthropathy); (2) Conservative care failure ≥3 months; (3) ASES <50 AND active forward elevation <120°; (4) Anatomic TSA: intact/reparable cuff on MRI; Reverse TSA: massive irreparable cuff tear with intact deltoid; (5) Bone stock assessment if significant glenoid wear Always confirm against the current Humana policy.

How long does a Humana prior authorization take?

Humana typically decides Total Shoulder Arthroplasty requests in about 3 days. Timeframes vary; check the payer portal.

Submitting Total Shoulder Arthroplasty to Humana?

Praxigen checks your clinical note against these criteria before you submit and drafts a policy-cited appeal if it is denied. You review and submit; nothing is sent automatically.

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Other Humana prior authorization requirements

Anterior Cervical Discectomy and FusionArthroscopic Hip Surgery for Impingement Syndrome Including Labral RepairDorsal Column (Lumbar) Neurostimulators: Trial or ImplantationKnee ArthroscopyLumbar Spinal FusionPain Injections - SpineShoulder Arthroplasty Including Revision ProceduresShoulder Arthroscopy Rotator Cuff RepairTotal Knee ArthroplastyViscosupplements

Related guides

Why was my prior authorization denied? Top reasons and how to fix eachHow to write a prior authorization appeal that cites policy