Clinical, reimbursement, and administrative policy updates

May 17, 2024

To support access to quality, cost-effective care for your patients with a medical plan administered by Cigna Healthcare, we routinely review clinical, reimbursement, and administrative policies for potential updates. As a reminder, reimbursement and modifier policies apply to all claims, including those for your patients with “G” ID cards.

Planned Cigna Healthcare Medicare Advantage policy updates*

Policy nameUpdateEffective date
Modifier 50 Bilateral Procedures (MAM50)We will administratively deny bilateral procedure codes when billed without the required modifier, LT (left side), RT (right side) or 50, as appropriate. August 17, 2024, for dates of service on or after this date.

*   Please note that the planned updates are subject to change. For the most up-to-date information, please visit the Cigna for Health Care Professionals website (CignaforHCP.com).

Additional information

For more information about our monthly policy updates, visit CignaforHCP.com > Resources > Coverage Policies > Policy Updates.

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