Beginning November 1, 2024, EviCore by Evernorth^® will begin managing precertification for certain Current Procedural Terminology (CPT^®) codes for spine surgeries and additional spine-related procedures for Cigna Healthcare^℠ customers. Precertification is required for our customers who receive these surgeries and procedures in an office, inpatient or outpatient setting.

How to request precertification

Please note that precertification for joint and pain management services will continue to be managed on the MedSolutions portal that you use today.

Precertification for the added spine services will be managed on the CareCore portal. Both the MedSolutions and CareCore portals are accessible through the EviCore provider portal. Use the contact information below to submit precertification requests:

Spine services added to program

The following spine surgery services require precertification through EviCore:

• Decompression procedures—laminectomy/laminotomy/laminoplasty
• Cervical, thoracic, lumbar, and sacrum fusions (including deformity correction)
• Vertebroplasty/kyphoplasty
• Basivertebral nerve ablation
• Revision surgery
• Total disc arthroplasty

For a complete list of CPT codes included in this program, go to EviCore.com/resources/healthplan/Cigna > Solution Resources > Musculoskeletal > CPT Codes > Spine surgery code list.

Provider orientation sessions

In October and November, EviCore will lead online sessions to help you and your staff understand the new precertification process. These sessions will include detailed information about the process, a review of how to access information on EviCore.com, and a question-and-answer period.

Please refer to these additional details and registration instructions. We encourage you and your staff to attend one of these sessions to ensure understanding of the precertification program requirements.

Additional information

• Medical coverage guidelines: eviCore.com/cignaguideline
• Resources: eviCore.com/resources/healthplan/Cigna > Solution Resources > Musculoskeletal
• Clinical support: EviCore welcomes requests for clinical discussions.
  • Telephone: 866.668.9250
  • Website: EviCore.com/provider/requests-a-clinical-consultation