3/5/2012
Cigna routinely reviews coverage positions, and reimbursement and administrative policies for potential updates. The following table provides a summary of updates effective May 21, 2012. Additional information is available on Cigna’s secure website for Health Care Professionals.
| Policy Name |
Updates Effective May 21, 2012 |
| Cognitive Rehabilitation |
- An individualized program of cognitive rehabilitation will be covered, as medically necessary, following a traumatic brain injury, acute brain insult, or cerebrovascular accident when certain requirements are met
- All existing guidelines will be applied to claims
|
| Continuous Passive Motion Devices |
- The device will only be covered when it is used for a knee-related procedure or rehabilitation; all other uses (e.g. elbow, shoulder, wrist, and hip) will be considered not medically necessary
- The CPM device will only be covered for up to 21 days
- CPT code E0935 will be denied as experimental, investigational, or unproven (EIU) when billed with any other ICD-9 code other than those listed as covered
- CPT code E0936 will always be denied EIU
|
| Electrical Stimulators |
- CPT codes E0720 and E0730 will be denied as experimental, investigational, or unproven (EIU) when billed with any ICD-9 code other than those listed as covered
- CPT code E0740 will be denied as EIU with all ICD-9 codes
|
|
Home Traction Devices
|
CPT codes E0830; E0840; E0849; E0850; E0855; E0856; and E0860 will be denied as experimental, investigational, or unproven for all indications and problems.
|
|
Neuro-Psychological Testing
|
CPT codes 96116, 96118, 96119, and 96120 will be denied as not medically necessary when billed with any ICD-9 code other than those listed as covered. |