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Cigna coverage policies, page 5 | Backwork

Payers/Cigna

Cigna coverage policies

219 active Cigna policies in Backwork, grouped by policy type. Each policy page shows the codes the policy lists and links to the payer’s own copy.

Summary of the payer’s published policy. Not a coverage determination — confirm with Cigna before submitting.

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Policy types

Medical Policy2
PayerPolicy217

Codes Cigna marks as requiring prior authorization

Policies

201–219 of 219, by type and title

PayerPolicy

CIGNA-0011

Transcatheter Closure of Cardiovascular Defects

Effective Nov 15, 2025

CIGNA-0501

Transcatheter Heart Valve Procedures

Effective Dec 15, 2025

CIGNA-EN0383

Transcranial Magnetic Stimulation

Effective Mar 15, 2026

CIGNA-UM-35

Transition of Care Service Requests For New Customers

Effective Sep 25, 2025

CIGNA-HM-CLN-037

Transition to or from a Group Benefit Plan Serviced by Behavioral Health

Effective Nov 11, 2025

CIGNA-0510

Transthoracic Echocardiography in Adults

Effective Sep 15, 2026

CIGNA-0523

Transthoracic Echocardiography in Children

Effective Sep 15, 2026

CIGNA-0398

Transvaginal Ultrasound, Non-Obstetrical

Effective Mar 15, 2026

CIGNA-0313

Treatment of Cutaneous and Vascular Lesions

Effective May 15, 2026

CIGNA-0313-FUTURE

Treatment of Cutaneous and Vascular Lesions

Effective Oct 15, 2026

CIGNA-0203

Tumor In Vitro Chemosensitivity and Chemoresistance Assays

Effective Apr 15, 2026

CIGNA-0139

Ultrasound Guidance for Trigger Point Injections

Effective Jul 15, 2026

CIGNA-0142

Ultrasound in Pregnancy (including 3D, 4D and 5D Ultrasound)

Effective Aug 15, 2026

CIGNA-0350

Vagus Nerve Stimulation (VNS)

Effective Feb 15, 2026

CIGNA-0560

Vascularized Composite Allograft (VCA) Transplant

Effective Jan 15, 2026

CIGNA-0054

Ventricular Assist Devices (VADs), Percutaneous Cardiac Support Systems and Total Artificial Heart

Effective Dec 15, 2025

CIGNA-0526

Vitamin D Testing

Effective Sep 15, 2026

CIGNA-A024

Wheelchairs/ Power Operated Vehicles

Effective Jun 14, 2026

CIGNA-0578

Wide-Area Transepithelial Tissue Sampling with Computer-Assisted 3D Analysis (WATS3D)

Effective Dec 15, 2025

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