Cigna Updates Electrical Stimulation Therapy and Devices Policy

July 2017 ~

Cigna has posted updates to its Electrical Stimulation Therapy and Devices policy and Preventive care code updates for fall prevention services.

The update to Cigna’s Electrical Stimulation Therapy policy and policy on Related Services, Supplies, Drugs and Equipment are as follows:

  • Related Services, Supplies, Drugs and Equipment (R27)
    • UPDATE: Cigna will implement a new policy, Related Services, Supplies, Drugs and Equipment (R27);
    • EFFECTIVE DATE: July 9, 2017, for claims processed on or after this date, whether or not the supplies are billed with the device or separately.
  • Electrical Stimulation Therapy and Devices (0160)
    • UPDATE: Cigna will deny reimbursement for supplies associated with Electrical Stimulation Therapy and Devices (0160) if the claim for the device was previously denied.

The Preventive Care Services Administrative Policy A004 updates, according to the insurer, relate to the designated wellness codes that are required for coverage of fall prevention services as a preventive service for community-dwelling adults, age 65 and older, who have risk factors.

Cigna’s preventive care code updates for fall prevention services effective April 1, 2017 include:

  • Continue to cover ICD-10 codes:
    • 81 – Muscle weakness (generalized)
    • R54 – Age-related physical debility
    • 81 – History of falling
  • Add ICD-10 code:
    • 81 – Unsteadiness on feet
  • Remove ICD-10 codes:
    • 89 – Encounter for other specified aftercare
    • xxxS – Unspecified fall, sequel
    • 3 – Lack of physical exercise
    • 9 – Problem related to lifestyle, unspecified

These policy updates can be found on the Cigna for Health Care Professionals website and on the Preventive Care Services page.

 

Source(s): Cigna;

 

 

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