Preventive care services policy updates

April 1, 2024

During the first quarter of 2024, updates became effective for the Cigna Healthcare Preventive Care Services Administrative Policy (A004).

Routine immunization: COVID-19Added five and removed 52 Current Procedural Terminology (CPT®) codes to reflect American Medical Association (AMA) coding changesAdded: 91318–91322.
Removed: 0001A–0004A, 0011A–0013A, 0031A, 0034A, 0041A, 0042A, 0044A, 0051A–0054A, 0064A, 0071A–0074A, 0081A–0083A, 0091A–0094A, 0111A–0113A, 0124A, 0134A, 0144A, 0154A, 0164A, 0173A, 0174A, 91300, 91301, 91303–91309, 91311–91317
Routine immunization: Influenza vaccineRemoved 10 CPT codes and one Healthcare Common Procedure Coding System (HCPCS) code to reflect AMA coding changesCPT: 90653–90658, 90660–90661, 90673, 90685
HCPCS: Q2037
Routine immunization: respiratory syncytial virus (RSV)Added six CPT codes and one International Classification of Diseases, 10th Revision (ICD-10) code to reflect AMA coding changesCPT: 90380, 90381, 90678, 90679, 96380, 96381
ICD-10: Z29.22
Cholesterol screeningRemoved one CPT code as it does not reflect a preventive service83719
Code Group 1 diagnosesAdded six ICD-10 codes to reflect AMA coding changes; removed one ICD-10 code as it is no longer a billable codeAdded: Z29.81, Z83.71, Z83.710, Z83.711, Z83.718, Z83.719
Removed: Z13.4
Fluoride applicationAdded one CPT code to reflect an additional type of fluoride application as a new preventive service0792T
HIV infection: PrEP injection cabotegravir (apretude)Added one HCPCS code and one ICD-10 code for prevention of human immunodeficiency virus (HIV) infection: Pre-exposure prophylaxis (PrEP) injection cabotegravir (apretude) as it is a new preventive serviceHCPCS: J0739
ICD-10: Z29.81
Hearing screeningRemoved two CPT codes as they do not represent preventive services92652, 92653

For additional guidance on preventive care services, refer to the Preventive Care Services Administrative Policy (A004) on the Cigna for Health Care Professionals website ( > Review coverage policies > Medical and Administrative A-Z Index > Preventive Care Services – (A004).

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