MedicaidCoverageMedium impact
Uterine Fibroid Surgical Treatments - MEDICAID - KENTUCKY (Revised)
Humana·KY · OB-GYN·Medicaid
Effective date
Jul 22, 2026
We identified it
Jul 23, 2026
Summary
Humana Kentucky Medicaid will NOT cover cryoablation procedures for uterine fibroids (CPT 58578, 58999), effective 07/22/2026. The policy states there is insufficient medical evidence to support this as standard treatment. Prior authorization is required, but will be denied. This represents a non-coverage determination for a specific surgical intervention.
Action Required
Before July 22, 2026: Billing team must update prior authorization protocols to flag and DENY all requests for CPT 58578 (unlisted laparoscopy, uterus) and CPT 58999 (unlisted procedure, female genital system) when submitted for Humana Kentucky Medicaid members. Add denial template citing insufficient evidence per policy HUM-KY-2231-001. Notify providers in OB/GYN department that cryoablation for uterine fibroids is not a covered service and will not be approved regardless of clinical documentation. Update billing system to automatically route these codes to prior authorization review with pre-populated denial language. Members under age 21 may request EPSDT review, but standard expectation is denial unless medical director override is justified.