Cigna policy
Ultrasound in Pregnancy (including 3D, 4D and 5D Ultrasound)
Ultrasound in Pregnancy (including 3D, 4D and 5D Ultrasound) is a public Cigna policy (policy 0142, effective Aug 15, 2026). It lists 4 CPT or HCPCS codes. Not a coverage decision; the payer's own document governs.
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- Payer
- Cigna
- Policy number
- 0142
- Effective
- Aug 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 |
|---|---|
| 76376 | Policies naming 76376 |
| 76377 | Policies naming 76377 |
| 76815 | Policies naming 76815 |
| 76816 | Policies naming 76816 |