Cigna stops requiring prior authorization for certain CT imaging exams
Commercial health insurer Cigna stopped requiring prior authorization for certain CT exams on Feb. 1, drawing praise from imaging industry advocates.
Beginning on Monday, the Bloomfield, Connecticut-based payer will eliminate such upfront coverage check-ins for computed tomography angiograms of the heart, coronary arteries and bypass grafts with contrast. This includes 3D image post-processing, and the insurer is also eliminating pre-authorization for fractional flow reserve-CT, too.
“The favorable policy update shows that Cigna recognizes the use of CTA and FFR-CT as a front-line test which can lead to improved patient outcomes,” Dustin Thomas, MD, chairman of the Society of Cardiovascular Computed Tomography’s Advocacy Committee, said in a statement.
Monday’s change removes all prior authorization requirements for Current Procedural Terminology code 75574, the SCCT noted, in all markets with Cigna eviCore healthcare, except for Hawaii, Puerto Rico and Guam. In order to gain coverage for these heart scans, however, patients must have stable chest pain and intermediate risk of coronary artery disease.
You can read more about the update on page 187 of Cigna’s master pre-certification list for providers here.
Marty Stempniak has covered healthcare since 2012, with his byline appearing in the American Hospital Association's member magazine, Modern Healthcare and McKnight's. Prior to that, he wrote about village government and local business for his hometown newspaper in Oak Park, Illinois. He won a Peter Lisagor and Gold EXCEL awards in 2017 for his coverage of the opioid epidemic.