Billing & Coding: Cigna Will Not Pay CPT Codes 97026 & 97016

Welcome to your billing and coding weekly solutions by American Acupuncture Council Network (AAC).

Are you aware there are CPT codes no longer covered by Cigna?

Effective March 15, 2021, Cigna will no longer pay for claims that include:

CPT Code 97026 Heat Lamp
CPT Code 97016 Vasopneumatic Devices

Cigna sent a letter to all providers in December 2020 and January  2021 stating these modalities (97026 & 97016) are not medically necessary, which applies to Acupuncturists, Chiropractors, and Physical Therapists.

*Medical Necessity appeal rights will be available for those who wish to appeal.

Remember, billing with incorrect acupuncture CPT and ICD codes can lead to claim rejections and delays in payments, which can have a devastating impact on generating revenue and keeping you in business. 

If you are experiencing insurance claim denial, staff spending too much time trying to get claims paid, and patients asking why their claims have not been paid then American Acupuncture Council Network is your solution.

American Acupuncture Council Network stays ahead of the curve on the latest trends and changes in billing and coding by utilizing their direct channel of communication with the insurance companies and organizations that set the guidelines.

There is a reason acupuncturists have trusted AAC with their business for over 30 years.