REVENUE CODE LIST-CPT-HCPCS - Cigna

1 All Cigna products and services are provided exclusively by or through operating subsidiaries of Cigna Corporation, including Cigna Health and life insurance Company, Connecticut General life insurance Company, Cigna Behavioral Health, Inc., and HMO or service company subsidiaries of Cigna Health Corporation. The Cigna name, logo, and other Cigna marks are owned by Cigna Intellectual Property, Inc. PCOMM-2020-036. 2020 Cigna . Some content provided under license. REVENUE Code Description 240 All inclusive ancillary, general 260 Intravenous (IV) therapy 261 Intravenous (IV) therapy, infusion pump 262 Intravenous (IV) therapy, pharmacy services 263 Intravenous (IV) therapeutic drug, supply and delivery 264 Intravenous (IV) therapy, supplies 269 Intravenous (IV)

2 Therapy, other 274 Medical/surgical supplies and devices, prosthetic/orthotic devices 280 Oncology 290 Durable medical equipment, general 291 Durable medical equipment, rental 292 Durable medical equipment, purchase of new 294 Durable medical equipment, supplies and drugs 299 Durable medical equipment, other 300 Laboratory, general classification 301 Laboratory, chemistry 302 Laboratory, immunology 303 Laboratory, renal patient (home) 304 Laboratory, dialysis 305 Laboratory, hematology 306 Laboratory, bacteriology and microbiology 307 Laboratory, urology 308 Reserved laboratory 309 Laboratory, other 310 Laboratory, pathology general classification 311 Laboratory pathology cytology 312 Laboratory pathology histology 313 Reserved laboratory pathology 314 Laboratory, pathology biopsy 315 Reserved laboratory, pathology 316 Reserved laboratory, pathology 317 Reserved laboratory, pathology 318 Reserved laboratory, pathology REVENUE CODE LIST-CPT-HCPCS For Providers Effective March 15.

3 2020 All Cigna products and services are provided exclusively by or through operating subsidiaries of Cigna Corporation, including Cigna Health and life insurance Company, Connecticut General life insurance Company, Cigna Behavioral Health, Inc., and HMO or service company subsidiaries of Cigna Health Corporation. The Cigna name, logo, and other Cigna marks are owned by Cigna Intellectual Property, Inc. PCOMM-2020-036. 2020 Cigna . Some content provided under license. 319 Laboratory, pathology other 320 Radiology, diagnostic general classification 321 Radiology, diagnostic angiocardiology 322 Radiology, diagnostic arthrography 323 Radiology, diagnostic arteriography 324 Radiology, diagnostic chest X-ray 325 Reserved radiology, diagnostic 326 Reserved radiology, diagnostic 327 Reserved radiology, diagnostic 328 Reserved radiology, diagnostic 329 Radiology, diagnostic other 330 Radiology, therapeutic chemotherapy general classification 331 Radiology, therapeutic chemotherapy, chemotherapy administration injected 332 Radiology, therapeutic chemotherapy.

4 Chemotherapy administration oral 333 Radiology, therapeutic chemotherapy, radiation therapy 334 Reserved radiology, therapeutic chemotherapy 335 Radiology, therapeutic chemotherapy, administration intravenous (IV) 336 Reserved radiology, therapeutic chemotherapy 337 Reserved radiology, therapeutic chemotherapy 338 Reserved radiology, therapeutic chemotherapy 339 Radiology, therapeutic chemotherapy other 340 Nuclear medicine, general classification 341 Nuclear medicine, diagnostic 342 Nuclear medicine, therapeutic 343 Nuclear medicine, diagnostic radiopharmaceuticals 344 Nuclear medicine, therapeutic radiopharmaceuticals 349 Nuclear medicine, other 350 Computerized axial tomography (CAT) scan, general 351 Computerized axial tomography (CAT) scan, head scan 352 Computerized axial tomography (CAT)

5 Scan, body scan 353 Reserved computerized axial tomography (CAT) scan 354 Reserved computerized axial tomography (CAT) scan 355 Reserved computerized axial tomography (CAT) scan 356 Reserved computerized axial tomography (CAT) scan 357 Reserved computerized axial tomography (CAT) scan 358 Reserved computerized axial tomography (CAT) scan All Cigna products and services are provided exclusively by or through operating subsidiaries of Cigna Corporation, including Cigna Health and life insurance Company, Connecticut General life insurance Company, Cigna Behavioral Health, Inc., and HMO or service company subsidiaries of Cigna Health Corporation.

6 The Cigna name, logo, and other Cigna marks are owned by Cigna Intellectual Property, Inc. PCOMM-2020-036. 2020 Cigna . Some content provided under license. 359 Computerized axial tomography (CAT) scan, other 360 Operating room services, general 361 Operating room services, minor surgery 362 Operating services, organ transplant other than kidney 363 Reserved operating room services 364 Reserved operating room services 365 Reserved operating room services 366 Reserved operating room services 367 Operating room services, kidney transplant 368 Reserved operating room services 369 Operating room services 380 Blood and blood products, general 381 Blood and blood products, packed red cells 382 Blood and blood products, whole blood products 383 Blood and blood products.

7 Plasma 384 Blood and blood products, platelets 385 Blood and blood products, leukocytes 386 Blood and blood products, other components 387 Blood and blood products, other derivatives (cryoprecipitate) 388 Blood and blood products, reserved components 389 Blood and blood products, other 390 Blood administration process, storage general 391 Blood administration process, storage administration 399 Blood, other storage 400 Imaging services, general 401 Imaging services, diagnostic mammography 402 Imaging services, ultrasound 403 Imaging services, screening mammography 404 Imaging services, positron emission tomography 405 Reserved imaging services 406 Reserved imaging services 407 Reserved imaging services 408 Reserved imaging services 409 Imaging services, other 410 Respiratory services.

8 General 411 Reserved respiratory services 412 Respiratory services, inhalation 413 Respiratory services, hyperbaric oxygen therapy 414 Reserved respiratory services 415 Reserved respiratory services 416 Reserved respiratory services 417 Reserved respiratory services All Cigna products and services are provided exclusively by or through operating subsidiaries of Cigna Corporation, including Cigna Health and life insurance Company, Connecticut General life insurance Company, Cigna Behavioral Health, Inc., and HMO or service company subsidiaries of Cigna Health Corporation. The Cigna name, logo, and other Cigna marks are owned by Cigna Intellectual Property, Inc.

9 PCOMM-2020-036. 2020 Cigna . Some content provided under license. 418 Reserved respiratory services 419 Respiratory services, other 420 Physical therapy, general 421 Physical therapy, visit 422 Physical therapy, hourly 423 Physical therapy, group 424 Physical therapy, evaluation or reevaluation 425 Reserved physical therapy 426 Reserved physical therapy 427 Reserved physical therapy 428 Reserved physical therapy 429 Physical therapy, other 430 Occupational therapy, general 431 Occupational therapy, visit 432 Occupational therapy, hourly 433 Occupational therapy, group 434 Occupational therapy.

10 Evaluation or reevaluation 435 Reserved occupational therapy 436 Reserved occupational therapy 437 Reserved occupational therapy 438 Reserved occupational therapy 439 Occupational therapy, other 440 Speech therapy, general 441 Speech therapy, visit 442 Speech therapy, hourly 443 Speech therapy, group 444 Speech therapy, evaluation or reevaluation 445 Reserved speech therapy 446 Reserved speech therapy 447 Reserved speech therapy 448 Reserved speech therapy 449 Speech therapy, other 450 Emergency room, general 451 Emergency room, EMTALA emergency medical screening 452 Emergency room, beyond EMTALA screening 453 Reserved emergency room 454 Reserved emergency room 455 Reserved emergency room 456 Emergency room, urgent care 457 Reserved emergency room 458 Reserved emergency room 459 Emergency room, other 460 Pulmonary function, general All Cigna products and services are provided exclusively by or through operating subsidiaries of Cigna Corporation, including Cigna Health and life insurance Company, Connecticut General life insurance Company, Cigna Behavioral Health, Inc.