Lower extremity prosthesis, myoelectric — prior authorization under Humana
Billing code L5856 · Category: dme
In our reference, this procedure typically requires prior authorization.
Typical turnaround is 14 day(s); Humana's
standard turnaround is 14 calendar days (72 hours if urgent).
How to submit
Availity portal, Humana Provider Portal, 800-448-6262
Documentation typically required
K-level assessment
PT evaluation
Prosthetist recommendation
Common reasons this gets denied
Functional level (K-level) not met
Rehab potential unclear
Humana-specific notes
Medicare Advantage has separate PA list from commercial
CareCore for advanced imaging
Post-acute care requires InterQual criteria
Coverage limits: this page does not confirm authorization for any specific member's plan, and does not cover state-specific plan variants, out-of-network requests, or every payer x procedure pair in existence. For a definitive answer, contact Humana directly using the submission method above.
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