Cigna policy
High Intensity Focused Ultrasound (HIFU)
High Intensity Focused Ultrasound (HIFU) is a public Cigna policy (policy 0274, effective Dec 15, 2025). It lists 5 CPT or HCPCS codes. Not a coverage decision; the payer's own document governs.
View the original policy (PDF) ↗
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- Payer
- Cigna
- Policy number
- 0274
- Effective
- Dec 15, 2025
- Line of business
- Commercial
- Source
- static.cigna.com
Codes in this policy
The CPT and HCPCS codes the policy names. A policy can name a code it excludes. Open official prior authorization lists to check the member’s product.
| Code | Other Cigna policies |
|---|---|
| 51721 | Policies naming 51721 |
| 55880 | Policies naming 55880 |
| 55881 | Policies naming 55881 |
| 55882 | Policies naming 55882 |
| C9734 | Policies naming C9734 |