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Musculoskeletal Program Policy Updates - Cigna

Cigna and the Tree of Life logo are registered service marks of Cigna Intellectual Property, Inc., licensed for use by Cigna Corporation and its operating subsidiaries. All products and services are provided by or through such operating subsidiaries, including Connecticut General Life Insurance Company and Cigna Health and Life Insurance Company, and not by Cigna Corporation. THN-2015-376. 2015 Cigna . Some content provided under license. To help ensure our customers receive cost-effective and medically necessary care, we are committed to implementing programs that better align our coverage and administrative policies to the most up-to-date evidence-based medical literature and industry standards.

CMM 313 Hip Arthroplasty - Total and Partial . 27120, 27122, 27125, 27130, 27132, 27134, 27137, 27138, 27090, 27091, 27282, 27284, 27286 ; Procedures that will now require review for medical necessity as part of the new precertification requirements include: • Partial hip resurfacing arthroplasty • Total hip resurfacing arthroplasty

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