Cigna policy
Male Sexual Dysfunction Treatment: Non-pharmacologic
Male Sexual Dysfunction Treatment: Non-pharmacologic is a public Cigna policy (policy 0403, effective Jul 15, 2026). It lists 8 CPT or HCPCS codes. Not a coverage decision; the payer's own document governs.
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- Payer
- Cigna
- Policy number
- 0403
- Effective
- Jul 15, 2026
- 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 |
|---|---|
| 54400 | Policies naming 54400 |
| 54401 | Policies naming 54401 |
| 54405 | Policies naming 54405 |
| 64912 | Policies naming 64912 |
| 64913 | Policies naming 64913 |
| 64999 | Policies naming 64999 |
| C1813 | Policies naming C1813 |
| C2622 | Policies naming C2622 |