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Cigna policies, page 4

Search Cigna's public medical, payment and drug policies by CPT or HCPCS code, keyword or policy number, with links to the payer's own documents. Links open the payer's own document; check its current version before relying on it.

246 public policies Substrate tracks for Cigna, by title.

Cigna policies
PolicyDetailsCodesSource
Mammary Ductoscopy, Aspiration and Lavage0057 · Effective Jan 15, 2026 · Commercial1Original policy ↗
Manipulation Under Anesthesia0276 · Effective Sep 15, 2026 · Commercial25Original policy ↗
Master Outpatient Precertification ListCommercial2,278Original policy ↗
Master Precertification ListCommercial2,245Original policy ↗
Master Precertification List - Removed CodesCommercial505Original policy ↗
Master Precertification List - Removed Codes For Health Care ProvidersCommercial484Original policy ↗
Metatarsophalangeal Joint Replacement0446 · Effective Sep 15, 2025 · Commercial5Original policy ↗
Midwife, Home Birth and Non-Clinical Maternal ServicesA002 · Effective Aug 8, 2026 · Commercial—Original policy ↗
Minimally Invasive Anti-Reflux Procedures and Peroral Endoscopic Myotomy (POEM) Procedures0019 · Effective Sep 15, 2026 · Commercial9Original policy ↗
Miscellaneous Musculoskeletal Procedures0515 · Effective Jun 15, 2026 · Commercial20Original policy ↗
Molecular and Proteomic Diagnostic Testing for Hematology and Oncology Indications0520 · Effective Oct 1, 2026 · Commercial33Original policy ↗
Mucosal Integrity Testing0577 · Effective Oct 15, 2025 · Commercial1Original policy ↗
Negative Pressure Wound Therapy/Vacuum Assisted Closure (VAC) for Nonhealing Wounds0064 · Effective May 15, 2026 · Commercial3Original policy ↗
Network Adequacy Provision (NAP)UM-20 · Effective May 1, 2004 · Commercial—Original policy ↗
Neuropsychological TestingEN0258 · Effective Sep 15, 2026 · Commercial8Original policy ↗
Non-Participating Laboratory ServicesA001 · Effective Aug 8, 2026 · Commercial—Original policy ↗
Nucleic Acid Pathogen Testing0530 · Effective Oct 1, 2026 · Commercial57Original policy ↗
Occupational TherapyCPG155 · Effective Dec 15, 2025 · Commercial77Original policy ↗
Open Neuroplasty Lumbar Plexus0587 · Effective Dec 1, 2025 · Commercial1Original policy ↗
Open Neuroplasty Lumbar Plexus0587 · Effective Dec 15, 2026 · Commercial1Original policy ↗
Orthognathic Surgery0209 · Effective Oct 15, 2025 · Commercial45Original policy ↗
Orthotic Devices and Shoes0543 · Effective Oct 1, 2026 · Commercial349Original policy ↗
Otoplasty and External Ear Reconstruction0335 · Effective Jul 15, 2026 · Commercial6Original policy ↗
Pancreatic Islet Cell Transplantation0107 · Effective Jun 15, 2026 · Commercial10Original policy ↗
Panniculectomy and Abdominoplasty0027 · Effective Jun 15, 2026 · Commercial5Original policy ↗
Partial Rhinectomy, Rhinoplasty, Vestibular Stenosis Repair and Septoplasty0119 · Effective Jul 1, 2026 · Commercial20Original policy ↗
Patient Assessments: Medical Necessity Decision Assist Guideline for Evaluations and Re-evaluationsCPG111 · Effective Jul 15, 2026 · Commercial35Original policy ↗
Pelvic Denervation Procedures0368 · Effective Jun 15, 2026 · Commercial2Original policy ↗
Percutaneous Electrical Nerve Field Stimulation (PENFS)0589 · Effective Sep 15, 2026 · Commercial2Original policy ↗
Peripheral Nerve Destruction for Pain Conditions0525 · Effective Sep 15, 2026 · Commercial10Original policy ↗
Peripheral Nerve Stimulation and Peripheral Nerve Field Stimulation0539 · Effective Mar 15, 2026 · Commercial26Original policy ↗
Pharmacogenetic Testing0500 · Effective Jul 15, 2026 · Commercial32Original policy ↗
Physical Performance Test or MeasurementCPG295 · Effective Nov 15, 2025 · Commercial6Original policy ↗
Physical TherapyCPG135 · Effective Dec 15, 2025 · Commercial81Original policy ↗
Plantar Fasciitis Treatments0097 · Effective May 15, 2026 · Commercial14Original policy ↗
Plasma Brain Natriuretic Peptide in the Outpatient Setting0028 · Effective Sep 15, 2026 · Commercial3Original policy ↗
Plasmapheresis0153 · Effective Jun 15, 2026 · Commercial1Original policy ↗
PrecertificationR21 · Effective Apr 1, 2011 · Commercial—Original policy ↗
Precertification ChangesCommercial5Original policy ↗
Precertification ChangesCommercial13Original policy ↗
Precertification ChangesCommercial4Original policy ↗
Precertification Changes For Health Care ProvidersCommercial638Original policy ↗
Prescription Digital Therapeutics0565 · Effective Jun 15, 2026 · Commercial4Original policy ↗
Preventive Care ServicesA004 · Effective Oct 1, 2026 · Commercial516Original policy ↗
Prosthetic Devices0536 · Effective Jan 15, 2026 · Commercial27Original policy ↗
Radiofrequency Ablation for Thyroid Nodules0575 · Effective Oct 15, 2025 · Commercial2Original policy ↗
Radiofrequency Therapy for Fecal Incontinence0576 · Effective Oct 15, 2025 · Commercial1Original policy ↗
Range of Motion TestingCPG146 · Effective Jun 15, 2026 · Commercial8Original policy ↗
Redundant Skin Surgery0470 · Effective Sep 15, 2026 · Commercial17Original policy ↗
Remote Physiologic Monitoring (RPM) and Remote Therapeutic Monitoring (RTM)0563 · Effective May 15, 2026 · Commercial20Original policy ↗

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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.

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