Cigna policy

Master Outpatient Precertification List

Master Outpatient Precertification List is a public Cigna policy. It lists 2,278 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
Line of business
Commercial
Source
www.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.

CodeOther Cigna policies
0020MPolicies naming 0020M
0036UPolicies naming 0036U
0037UPolicies naming 0037U
0047UPolicies naming 0047U
0048UPolicies naming 0048U
0075TPolicies naming 0075T
0087UPolicies naming 0087U
0088UPolicies naming 0088U
0089UPolicies naming 0089U
0098TPolicies naming 0098T
0102UPolicies naming 0102U
0129UPolicies naming 0129U
0172UPolicies naming 0172U
0200TPolicies naming 0200T
0201TPolicies naming 0201T
0211UPolicies naming 0211U
0213TPolicies naming 0213T
0214TPolicies naming 0214T
0215TPolicies naming 0215T
0216TPolicies naming 0216T
0217TPolicies naming 0217T
0218TPolicies naming 0218T
0232TPolicies naming 0232T
0239UPolicies naming 0239U
0242UPolicies naming 0242U
0244UPolicies naming 0244U
0250UPolicies naming 0250U
0318UPolicies naming 0318U
0326UPolicies naming 0326U
0329UPolicies naming 0329U
0331TPolicies naming 0331T
0332TPolicies naming 0332T
0334UPolicies naming 0334U
0335TPolicies naming 0335T
0340UPolicies naming 0340U
0364UPolicies naming 0364U
0373TPolicies naming 0373T
0379UPolicies naming 0379U
0388UPolicies naming 0388U
0395TPolicies naming 0395T
0425UPolicies naming 0425U
0426UPolicies naming 0426U
0444UPolicies naming 0444U
0449TPolicies naming 0449T
0452UPolicies naming 0452U
0453UPolicies naming 0453U
0454UPolicies naming 0454U
0465UPolicies naming 0465U
0466UPolicies naming 0466U
0467UPolicies naming 0467U
0469UPolicies naming 0469U
0471UPolicies naming 0471U
0473UPolicies naming 0473U
0479TPolicies naming 0479T
0480TPolicies naming 0480T
0481UPolicies naming 0481U
0483TPolicies naming 0483T
0485UPolicies naming 0485U
0487UPolicies naming 0487U
0488UPolicies naming 0488U
0493UPolicies naming 0493U
0496UPolicies naming 0496U
0499UPolicies naming 0499U
0500UPolicies naming 0500U
0501UPolicies naming 0501U
0506UPolicies naming 0506U
0507UPolicies naming 0507U
0523UPolicies naming 0523U
0529UPolicies naming 0529U
0530UPolicies naming 0530U
0532UPolicies naming 0532U
0533UPolicies naming 0533U
0534UPolicies naming 0534U
0537UPolicies naming 0537U
0538UPolicies naming 0538U
0539UPolicies naming 0539U
0540UPolicies naming 0540U
0543UPolicies naming 0543U
0549UPolicies naming 0549U
0552UPolicies naming 0552U
0553UPolicies naming 0553U
0554UPolicies naming 0554U
0555UPolicies naming 0555U
0560UPolicies naming 0560U
0561UPolicies naming 0561U
0562UPolicies naming 0562U
0565UPolicies naming 0565U
0566UPolicies naming 0566U
0567UPolicies naming 0567U
0569UPolicies naming 0569U
0571TPolicies naming 0571T
0571UPolicies naming 0571U
0572UPolicies naming 0572U
0575UPolicies naming 0575U
0576UPolicies naming 0576U
0578UPolicies naming 0578U
0581UPolicies naming 0581U
0582UPolicies naming 0582U
0583UPolicies naming 0583U
0584TPolicies naming 0584T
0585TPolicies naming 0585T
0585UPolicies naming 0585U
0586TPolicies naming 0586T
0586UPolicies naming 0586U
0592UPolicies naming 0592U
0597UPolicies naming 0597U
0600TPolicies naming 0600T
0601TPolicies naming 0601T
0602UPolicies naming 0602U
0609TPolicies naming 0609T
0610TPolicies naming 0610T
0611TPolicies naming 0611T
0611UPolicies naming 0611U
0612TPolicies naming 0612T
0612UPolicies naming 0612U
0613UPolicies naming 0613U
0627TPolicies naming 0627T
0628TPolicies naming 0628T
0629TPolicies naming 0629T
0631UPolicies naming 0631U
0632UPolicies naming 0632U
0633TPolicies naming 0633T
0634TPolicies naming 0634T
0634UPolicies naming 0634U
0635TPolicies naming 0635T
0636TPolicies naming 0636T
0637TPolicies naming 0637T
0638TPolicies naming 0638T
0641UPolicies naming 0641U
0642UPolicies naming 0642U
0644UPolicies naming 0644U
0645UPolicies naming 0645U
0646UPolicies naming 0646U
0647UPolicies naming 0647U
0648TPolicies naming 0648T
0649TPolicies naming 0649T
0651UPolicies naming 0651U
0653UPolicies naming 0653U
0656TPolicies naming 0656T
0657TPolicies naming 0657T
0657UPolicies naming 0657U
0658UPolicies naming 0658U
0659UPolicies naming 0659U
0663UPolicies naming 0663U
0664TPolicies naming 0664T
0665TPolicies naming 0665T
0666TPolicies naming 0666T
0667TPolicies naming 0667T
0668TPolicies naming 0668T
0668UPolicies naming 0668U
0669TPolicies naming 0669T
0670TPolicies naming 0670T
0671TPolicies naming 0671T
0678UPolicies naming 0678U
0679UPolicies naming 0679U
0686UPolicies naming 0686U
0695UPolicies naming 0695U
0696UPolicies naming 0696U
0697TPolicies naming 0697T
0698TPolicies naming 0698T
0707TPolicies naming 0707T
0710TPolicies naming 0710T
0711TPolicies naming 0711T
0712TPolicies naming 0712T
0713TPolicies naming 0713T
0717TPolicies naming 0717T
0718TPolicies naming 0718T
0745TPolicies naming 0745T
0746TPolicies naming 0746T
0747TPolicies naming 0747T
0805TPolicies naming 0805T
0806TPolicies naming 0806T
0807TPolicies naming 0807T
0808TPolicies naming 0808T
0813TPolicies naming 0813T
0865TPolicies naming 0865T
0866TPolicies naming 0866T
0869TPolicies naming 0869T
0889TPolicies naming 0889T
0890TPolicies naming 0890T
0891TPolicies naming 0891T
0892TPolicies naming 0892T
0899TPolicies naming 0899T
0900TPolicies naming 0900T
0908TPolicies naming 0908T
0933TPolicies naming 0933T
0947TPolicies naming 0947T
0950TPolicies naming 0950T
0951TPolicies naming 0951T
0956TPolicies naming 0956T
0957TPolicies naming 0957T
0959TPolicies naming 0959T
0960TPolicies naming 0960T
0967TPolicies naming 0967T
0968TPolicies naming 0968T
0978TPolicies naming 0978T
0979TPolicies naming 0979T
0980TPolicies naming 0980T
0981TPolicies naming 0981T
0990TPolicies naming 0990T
0991TPolicies naming 0991T
0994TPolicies naming 0994T
0995TPolicies naming 0995T
0997TPolicies naming 0997T
0998TPolicies naming 0998T
0999TPolicies naming 0999T
1000TPolicies naming 1000T
1001TPolicies naming 1001T
1003TPolicies naming 1003T
1008TPolicies naming 1008T
1009TPolicies naming 1009T
1019TPolicies naming 1019T
1025TPolicies naming 1025T
1037TPolicies naming 1037T
1038TPolicies naming 1038T
1039TPolicies naming 1039T
1050TPolicies naming 1050T
1056TPolicies naming 1056T
1057TPolicies naming 1057T
1080TPolicies naming 1080T
1081TPolicies naming 1081T
1082TPolicies naming 1082T
1083TPolicies naming 1083T
1084TPolicies naming 1084T
1091TPolicies naming 1091T
1092TPolicies naming 1092T
1093TPolicies naming 1093T
1094TPolicies naming 1094T
1095TPolicies naming 1095T
1099TPolicies naming 1099T
11950Policies naming 11950
11951Policies naming 11951
11952Policies naming 11952
11954Policies naming 11954
11980Policies naming 11980
15011Policies naming 15011
15012Policies naming 15012
15013Policies naming 15013
15014Policies naming 15014
15015Policies naming 15015
15016Policies naming 15016
15017Policies naming 15017
15018Policies naming 15018
15150Policies naming 15150
15151Policies naming 15151
15152Policies naming 15152
15155Policies naming 15155
15156Policies naming 15156
15157Policies naming 15157
15271Policies naming 15271
15272Policies naming 15272
15273Policies naming 15273
15274Policies naming 15274
15275Policies naming 15275
15276Policies naming 15276
15277Policies naming 15277
15278Policies naming 15278
15769Policies naming 15769
15771Policies naming 15771
15772Policies naming 15772
15773Policies naming 15773
15774Policies naming 15774
15777Policies naming 15777
15778Policies naming 15778
15786Policies naming 15786
15787Policies naming 15787
15820Policies naming 15820
15821Policies naming 15821
15822Policies naming 15822
15823Policies naming 15823
15824Policies naming 15824
15825Policies naming 15825
15828Policies naming 15828
15829Policies naming 15829
15830Policies naming 15830
15832Policies naming 15832
15833Policies naming 15833
15834Policies naming 15834
15835Policies naming 15835
15836Policies naming 15836
15837Policies naming 15837
15838Policies naming 15838
15839Policies naming 15839
15847Policies naming 15847
15876Policies naming 15876
15877Policies naming 15877
15878Policies naming 15878
15879Policies naming 15879
17106Policies naming 17106
17107Policies naming 17107
17108Policies naming 17108
17999Policies naming 17999
19294Policies naming 19294
19296Policies naming 19296
19297Policies naming 19297
19298Policies naming 19298
19300Policies naming 19300
19316Policies naming 19316
19318Policies naming 19318
19325Policies naming 19325

And 1,978 more in the original policy.

All Cigna policies · Cigna prior authorization CPT list

Disclaimer

The information provided on this page is for general informational purposes only and does not constitute billing, coding, or reimbursement advice. Nothing on this page should be relied upon as a substitute for clinician assessment, professional billing guidance, or as a definitive statement of any payor's billing requirements or policies.

Payor agreements, fee schedules, and billing policies vary and are subject to change. Before submitting any claims related to maternity care services, including claims affected by the 2027 CPT code revisions, please consult the applicable payor agreements, coverage policies, and billing guidelines to confirm current requirements for their specific payor contracts.

Substrate makes no representation or warranty regarding the accuracy, completeness, or timeliness of the payor-specific information presented here. Providers are solely responsible for ensuring that all claims are submitted in accordance with applicable payor requirements, and Substrate assumes no liability for claim denials, underpayments, or other adverse outcomes arising from reliance on this information.