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Wheelchairs/Power Operated Vehicles - Cigna

    https://static.cigna.com/assets/chcp/pdf/coveragePolicies/medical/mm_0030_coveragepositioncriteria_wheelchairs_power_operated_vehicles.pdf
    This Coverage Policy addresses criteria related to standard manual wheelchairs, specialized manual wheelchairs and strollers, power mobility devices, power operated vehicles (POV), power wheelchairs (PWC), a custom motorized/power wheelchair …

Medical Necessity Criteria - Cigna

    https://www.cigna.com/static/www-cigna-com/docs/health-care-providers/medicalnecessitycriteria.pdf
    Medical Necessity Criteria - Cigna

Access Coverage Policies | Cigna

    https://www.cigna.com/health-care-providers/coverage-and-claims/policies/
    Accidental Injury, Critical Illness, and Hospital Care plans or insurance policies are distributed exclusively by or through operating subsidiaries of Cigna Corporation, are …

Medical Supplies Coverage Policies | Cigna

    https://www.cigna.com/health-care-providers/coverage-and-claims/policies/medical-supplies
    Accidental Injury, Critical Illness, and Hospital Care plans or insurance policies are distributed exclusively by or through operating subsidiaries of Cigna Corporation, are …

Child Safety: Strollers and Shopping Carts | Cigna

    https://www.cigna.com/knowledge-center/hw/child-safety-ue5157
    Accidental Injury, Critical Illness, and Hospital Care plans or insurance policies are distributed exclusively by or through operating subsidiaries of Cigna Corporation, are …

Hospital Beds and Accessories - Cigna

    https://static.cigna.com/assets/chcp/pdf/coveragePolicies/medical/mm_0273_coveragepositioncriteria_hospital_beds_and_accessories.pdf
    heavy-duty, extra-wide/bariatric bed (HCPCS codes E0301, E0303), when criteria are met for a fixed-height bed and the individual’s weight is more than 350 pounds but less than …

Seat Lift Mechanisms, Patient Lifts and Standing …

    https://static.cigna.com/assets/chcp/pdf/coveragePolicies/medical/mm_0343_coveragepositioncriteria_seat_lift_mechanisms_patient_lifts.pdf
    individual meets criteria for a patient lift individual has a medical condition requiring a supine transfer combination transfer and mobility device (i.e., Rifton TRAM, Rifton E …

Orthotic Devices and Shoes - Cigna

    https://static.cigna.com/assets/chcp/pdf/coveragePolicies/medical/mm_0543_coveragepositioncriteria_orthotic_devices_shoes.pdf
    meets the above medical necessity criteria for an AFO or KAFO is considered medically necessary when ANY of the following criteria applies: The individual cannot be fitted …

Bariatric Surgery and Procedures - Cigna

    https://static.cigna.com/assets/chcp/pdf/coveragePolicies/medical/mm_0051_coveragepositioncriteria_bariatric_surgery.pdf
    When the specific medical necessity criteria noted above for bariatric surgery for an adult have been met, ANY of the following open or laparoscopic bariatric surgical …

Cigna Medical Coverage Policy

    https://www.cigna.com/assets/docs/health-care-professionals/future_coverage_positions/mm_0158_coveragepositioncriteria_obstructive_sleep_apnea_diag_trtment_svc.pdf
    • medical necessity criteria for a sleep study for suspected obstructive sleep apnea (OSA) as outlined above have been met • apnea/hypopnea index (AHI) of 40 or higher during …



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