Cigna scraps plan to not pay for clinical pathology services

Cigna has decided to not follow through on a new policy to stop paying for the professional component of clinical pathology services…at least for now.  Cigna announced it will no longer reimburse for the PC (-26 modifier) of clinical pathology services when they are “billed with lab and other codes with CMS designation 3 or 9 indicators.”  According to Cigna’s policy manual for the -26 modifier, Indicator 3 is “Technical Component only” and Indicator 9 is “TC/PC concept not applicable”. Due to the efforts of The College of American Pathologists, and labs who opposed Cigna’s proposed policy they provided the insurer with the information it needed to reconsider its decision. A copy of the Draft letter from Dr. Scott Josephs, National Medical Officer for Cigna is provided under the Source documents.