Cigna · PayerPolicy · CIGNA-CPG030
Summary of the payer’s published policy. Not a coverage determination — confirm with Cigna before submitting.
Free account. Policy pages stay open to everyone.
Each code’s status is what the policy records for it. This page does not show the policy’s criteria. Read them in the payer’s source.
| Code | Code system | Status in this policy |
|---|---|---|
| 97037 | CPT | Covered |
| 97039 | CPT | Not covered |
| S8948 | HCPCS | Covered |
| C00.00 | ICD10CM | Covered |
| C00.92 | ICD10CM | Covered |
| C02.0 | ICD10CM | Covered |
| C02.9 | ICD10CM | Covered |
| C03.0 | ICD10CM | Covered |
| C03.9 | ICD10CM | Covered |
| C04.0 | ICD10CM | Covered |
| C04.9 | ICD10CM | Covered |
| C05.0 | ICD10CM | Covered |
| C05.9 | ICD10CM | Covered |
| C06.0 | ICD10CM | Covered |
| C06.9 | ICD10CM | Covered |
| C07.0 | ICD10CM | Covered |
| C07.9 | ICD10CM | Covered |
| C08.0 | ICD10CM | Covered |
| C08.9 | ICD10CM | Covered |
| C09.0 | ICD10CM | Covered |
| C09.9 | ICD10CM | Covered |
| C10.0 | ICD10CM | Covered |
| C10.9 | ICD10CM | Covered |
| C11.0 | ICD10CM | Covered |
| C11.9 | ICD10CM | Covered |
| C12.0 | ICD10CM | Covered |
| C13.9 | ICD10CM | Covered |
| C14.0 | ICD10CM | Covered |
| C14.8 | ICD10CM | Covered |
| C15.0 | ICD10CM | Covered |
| C15.9 | ICD10CM | Covered |
| C16.0 | ICD10CM | Covered |
| C16.9 | ICD10CM | Covered |
| C17.0 | ICD10CM | Covered |
| C17.9 | ICD10CM | Covered |
| C18.0 | ICD10CM | Covered |
| C18.9 | ICD10CM | Covered |
| C19 | ICD10CM | Covered |
| C20 | ICD10CM | Covered |
| C21.0 | ICD10CM | Covered |
| C21.8 | ICD10CM | Covered |
| C22.0 | ICD10CM | Covered |
| C22.9 | ICD10CM | Covered |
| C23 | ICD10CM | Covered |
| C24.9 | ICD10CM | Covered |
| C25.0 | ICD10CM | Covered |
| C25.9 | ICD10CM | Covered |
| C26.0 | ICD10CM | Covered |
| C26.9 | ICD10CM | Covered |
| C30.0 | ICD10CM | Covered |
| C31.9 | ICD10CM | Covered |
| C32.0 | ICD10CM | Covered |
| C32.9 | ICD10CM | Covered |
| C33 | ICD10CM | Covered |
| C34.92 | ICD10CM | Covered |
| C37 | ICD10CM | Covered |
| C41.9 | ICD10CM | Covered |
| C43.0 | ICD10CM | Covered |
| C43.9 | ICD10CM | Covered |
| C44.0 | ICD10CM | Covered |
| C44.9 | ICD10CM | Covered |
| C45.0 | ICD10CM | Covered |
| C45.9 | ICD10CM | Covered |
| C46.0 | ICD10CM | Covered |
| C46.9 | ICD10CM | Covered |
| C47.0 | ICD10CM | Covered |
| C47.9 | ICD10CM | Covered |
| C48.0 | ICD10CM | Covered |
| C48.2 | ICD10CM | Covered |
| C49.0 | ICD10CM | Covered |
| C49.9 | ICD10CM | Covered |
| C50.011 | ICD10CM | Covered |
| C50.929 | ICD10CM | Covered |
| C51.0 | ICD10CM | Covered |
| C58.0 | ICD10CM | Covered |
| C60.00 | ICD10CM | Covered |
| C63.9 | ICD10CM | Covered |
| C64.1 | ICD10CM | Covered |
| C68.9 | ICD10CM | Covered |
| C69.0 | ICD10CM | Covered |
| C69.9 | ICD10CM | Covered |
| C70.0 | ICD10CM | Covered |
| C75.9 | ICD10CM | Covered |
| C76.0 | ICD10CM | Covered |
| C76.8 | ICD10CM | Covered |
| C77.0 | ICD10CM | Covered |
| C77.8 | ICD10CM | Covered |
| C78.01 | ICD10CM | Covered |
| C78.89 | ICD10CM | Covered |
| C79.01 | ICD10CM | Covered |
| C79.89 | ICD10CM | Covered |
| C79.9 | ICD10CM | Covered |
| C7A.00 | ICD10CM | Covered |
| C7A.8 | ICD10CM | Covered |
| C7B.00 | ICD10CM | Covered |
| C7B.8 | ICD10CM | Covered |
| C80.0 | ICD10CM | Covered |
| C80.2 | ICD10CM | Covered |
| C81.00 | ICD10CM | Covered |
| C96.9 | ICD10CM | Covered |
| D00.00 | ICD10CM | Covered |
| D00.2 | ICD10CM | Covered |
| D01.0 | ICD10CM | Covered |
| D01.9 | ICD10CM | Covered |
| D02.0 | ICD10CM | Covered |
| D02.21 | ICD10CM | Covered |
| D02.22 | ICD10CM | Covered |
| D02.4 | ICD10CM | Covered |
| D03.0 | ICD10CM | Covered |
| D03.9 | ICD10CM | Covered |
| D04.0 | ICD10CM | Covered |
| D04.9 | ICD10CM | Covered |
| D05.01 | ICD10CM | Covered |
| D05.92 | ICD10CM | Covered |
| D06.0 | ICD10CM | Covered |
| D06.9 | ICD10CM | Covered |
| D07.0 | ICD10CM | Covered |
| D07.69 | ICD10CM | Covered |
| D09.0 | ICD10CM | Covered |
| D09.3 | ICD10CM | Covered |
| D09.8 | ICD10CM | Covered |
| D09.9 | ICD10CM | Covered |
| D47.Z9 | ICD10CM | Covered |
| K12.30 | ICD10CM | Covered |
| K12.31 | ICD10CM | Covered |
| K12.33 | ICD10CM | Covered |
| K12.39 | ICD10CM | Covered |
| Z51.0 | ICD10CM | Covered |
| Z51.11 | ICD10CM | Covered |