Cigna to Keep Paying the Professional Component of Clinical Pathology Services

On April 12, 2021 Cigna issued an update to their Modifier 26 Professional Component policy, stating codes inappropriately billed with the 26 modifier will be denied effective 7/11/2021. This would eliminate reimbursement for Professional Component Clinical Laboratory billing from the Cigna fee schedule. News of this updated policy being rescinded for the foreseeable future brought about cheers from pathology groups around the country. This update from Cigna comes after they received strong push-back from multiple state societies, pathology practices, and industry advocacy groups, including the CAP.

Per the CAP Website:

In response to the CAP’s engagement, Cigna informed the CAP on June 7 that the decision is imminent. The CAP learned health insurance payer Cigna plans to continue reimbursing pathologists for the professional component of clinical pathology services. A formal update regarding the policy to pay for the professional component of clinical pathology would be forthcoming soon.

View our original announcement on this topic here: https://www.xifin.com/resources/industry-news/202104/cigna-stop-reimbursement-professional-component-clinical-pathology

Source: https://www.cap.org/advocacy/latest-news-and-practice-data/june-8-2021?utm_source=Jun.%20Wk2&utm_medium=Email&utm_campaign=Advocacy%20Update&utm_content=Advocacy%20Update&mkt_tok=MzA3LUhaWi01NDQAAAF9jCHH9DviKAyYXlrJzz9PvXs9zWZaUPdzElV3Br_xyzhqgW2CZU_2uM7zZi18LELB4CNts4DzN5C53jjmNqD_CPYkap0LLdYMuci_WsRD-A#story1