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Preventive Care Services - Cigna

Page 1 of 28 Administrative Policy: A004 Administrative Policy Effective 04/15/2018 Next Review Date .. 01/15/2019 Administrative Policy Number .. A004 Preventive Care Services Table of Contents Administrative Policy .. 1 Wellness Examinations - General Description .. 3 Frequency of Wellness Examinations .. 3 Preventive Care Services that may be provided during a Wellness Examination .. 3 Preventive Care Screenings and Interventions (Note: some Services may be provided as part of a wellness examination or at a separate encounter) .. 4 Coding/Billing Information .. 9 References .. 27 Related Coverage Resources Bone Mineral Density Measurement Breast Pumps Cervical Cancer Screening Visualization Technologies Colorectal Cancer Screening and Surveillance Genetic Testing for Hereditary Cancer Susceptibility Syndromes Human Papillomavirus Vaccine Mammography Screening No Cost-Share Preventive Medications by Drug Category Prostate-Specific Antigen (PSA) Screening for Prostate Cancer Routine Immunizations PURPOSE Administrative Policies are intended to provide further information about the administration of standard Cigna benefit plans.

(MAY require precertification or other reasonable medical management technique or practice depending on benefit plan design) Breast Cancer Screening: women age 40 and older, with or without clinical breast exam, every 1-2 years Note: ACA utilizes the 2002 USPSTF recommendations on breast cancer screening. 77065, 77066

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  Precertification, Cigna, Requires, Require precertification

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